Age, sex and gender impact multidimensional geriatric assessment in elderly cancer patients

Objectives: Multidimensional geriatric assessment (MGA) is essential in individualized treatment decisions in the elderly. The goal of this pilot study was to analyze the impact of age, sex and possibly gender on assessment status in senior cancer patients. Materials and methods: An MGA consisting of 12 scores was applied in 111 patients (range 60-99, median 75 years; 51% female). The effect of sex on individual MGA test results was evaluated by analysis of covariance adjusting for the confounding effect of age. The effect of age was investigated by partial correlation analysis adjusting for sex. Results: Women were significantly older than men (men 76.6 vs. 72.2 years, p=0.008), and advanced age was weakly associated with a reduced assessment status in most MGA dimensions. Age as a confounding factor was apparent in WHO performance status and in the "Timed Up and Go Test"; women's weaker performance status disappeared when adjusted for age. A significant effect of sex was observed in iADL (better functional activities in women), F-SozU (less perceived social support in women), BMI (lower BMI in women) and comorbidities (fewer comorbidities in women). The sex differences in iADL disappeared completely after omitting the gender-specific items in the iADL-5, thus implying a pronounced gender effect. Likewise, the significant difference in self-perceived emotional support (F-SozU 4.3 women vs. 4.6 men, p=0.005) suggests a gender effect in this dimension. Conclusion: Age, sex and gender need to be recognized and integrated as interplaying and confounding factors in the assessment of elderly cancer patients. (C) 2011 Elsevier Ltd. All rights reserved.