{"doi":"10.1002/cncr.34010","title":"Evaluating the association of frailty with communication about aging‐related concerns between older patients with advanced cancer and their oncologists","abstract":"BACKGROUND: A geriatric assessment (GA) intervention improves communication about aging-related concerns, but its effect on communication in patients with various levels of frailty is unknown. METHODS: This was a secondary analysis of a nationwide trial of patients aged ≥70 years with incurable cancer and impairment on 1 or more GA domains (ClinicalTrials.gov Identifier NCT02107443; principal investigator Supriya G. Mohile). Practice sites were randomized to either the GA-intervention or usual care. Frailty was assessed with a deficit accumulation index (range, 0-1), and patients were stratified as robust (0 to <0.2), prefrail (0.2 to <0.35), or frail (≥0.35). The clinic visit after the GA-intervention was audio-recorded, transcribed, and coded to evaluate the number and quality of conversations about aging-related concerns. Linear mixed models examined differences in the number and quality of conversations within and between arms. All P values were 2-sided. RESULTS: Patients (n = 541) were classified as robust (27%), prefrail (42%), or frail (31%). In the usual care arm, frail patients (vs robust ones) engaged in more aging-related conversations (adjusted mean difference, 1.73; 95% confidence interval [CI], 0.59-2.87), conversations of higher quality (difference, 1.12; 95% CI, 0.24-2.0), and more discussions about evidence-based recommendations (difference, 0.71; 95% CI, 0.04-1.38; all P values ≤ .01). Similarly, in the GA intervention arm, frail patients (vs robust ones) engaged in more aging-related conversations (difference, 2.49; 95% CI, 1.51-3.47), conversations of higher quality (difference, 1.31; 95% CI, 0.56-2.06), and more discussions about evidence-based recommendations (difference, 0.87; 95% CI, 0.32-1.42; all P values ≤ .01). Furthermore, the GA-intervention significantly improved the number and quality of conversations in all patients: robust, prefrail, and frail (all P values ≤ .01). CONCLUSIONS: Patients with higher degrees of frailty and those exposed to the GA-intervention had more and higher quality conversations about aging-related concerns with oncologists. LAY SUMMARY: A geriatric assessment (GA) intervention improves communication about aging-related concerns, but its effect on communication in patients with various levels of frailty is unknown. This study conducted a secondary analysis of a nationwide trial of patients aged ≥70 years with incurable cancer and 1 or more GA domain impairments. Patients were stratified as robust, prefrail, or frail. The number and quality of conversations about aging-related concerns that occurred during the clinic visit after the GA-intervention were determined. Patients with higher degrees of frailty and those in the GA intervention arm had more and higher quality conversations about aging-related concerns with oncologists.","journal":"Cancer","year":2021,"id":188044,"datarank":0.853831973480006,"base_score":2.8903717578961645,"endowment":2.8903717578961645,"self_citation_contribution":0.4335557636844247,"citation_network_contribution":0.42027620979558117,"self_endowment_contribution":0.4335557636844247,"citer_contribution":0.42027620979558117,"corpus_percentile":null,"corpus_rank":null,"citation_count":17,"citer_count":14,"citers_with_citation_signal":13,"citers_with_endowment":13,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.8487,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT02107443"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":266569,"name":"Huiwen Xu","orcid":"0000-0002-4033-0659","position":1,"is_corresponding":false},{"id":674930,"name":"Lee Kehoe","orcid":"0000-0002-3873-4777","position":2,"is_corresponding":false},{"id":420852,"name":"Amber S. Kleckner","orcid":"0000-0002-5088-1139","position":3,"is_corresponding":false},{"id":748999,"name":"Kiran Moorthi","orcid":null,"position":4,"is_corresponding":false},{"id":266568,"name":"Lianlian Lei","orcid":"0000-0003-0463-2614","position":5,"is_corresponding":false},{"id":266571,"name":"Mostafa Mohamed","orcid":"0000-0003-2936-5794","position":6,"is_corresponding":false},{"id":266580,"name":"Kah Poh Loh","orcid":"0000-0002-6978-0418","position":7,"is_corresponding":false},{"id":266567,"name":"Eva Culakova","orcid":"0000-0002-9852-6515","position":8,"is_corresponding":false},{"id":266574,"name":"Marie Flannery","orcid":"0000-0003-2957-8482","position":9,"is_corresponding":false},{"id":336515,"name":"Erika Ramsdale","orcid":"0000-0002-2246-168X","position":10,"is_corresponding":false},{"id":266573,"name":"Paul R. Duberstein","orcid":"0000-0001-6882-0898","position":11,"is_corresponding":false},{"id":584603,"name":"Beverly Canin","orcid":"0000-0001-7864-1121","position":12,"is_corresponding":false},{"id":266575,"name":"Charles Kamen","orcid":"0000-0002-4219-4320","position":13,"is_corresponding":false},{"id":748350,"name":"Gilbert Giri","orcid":"0000-0002-7161-091X","position":14,"is_corresponding":false},{"id":748351,"name":"Erin Watson","orcid":"0000-0002-8219-8318","position":15,"is_corresponding":false},{"id":550346,"name":"Amita Patil","orcid":"0000-0003-2526-9615","position":16,"is_corresponding":false},{"id":581758,"name":"Adedayo A. Onitilo","orcid":"0000-0001-9185-0606","position":17,"is_corresponding":false},{"id":722536,"name":"Brian L. Burnette","orcid":null,"position":18,"is_corresponding":false},{"id":278742,"name":"Michelle C. Janelsins","orcid":"0000-0003-2258-7247","position":19,"is_corresponding":false},{"id":266566,"name":"Supriya G. Mohile","orcid":"0000-0003-0867-327X","position":20,"is_corresponding":false},{"id":464930,"name":"Nikesha Gilmore","orcid":"0000-0002-5079-1723","position":0,"is_corresponding":true}],"reference_count":47,"raw_metadata":null,"created_at":"2026-07-18T23:49:05.976005Z","pmid":"34762734","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}