{"doi":"10.1111/jgs.18676","title":"Geriatric assessment‐derived deficit accumulation and patient‐reported treatment burden in older adults with bladder cancer","abstract":"BACKGROUND: When a person's workload of healthcare exceeds their resources, they experience treatment burden. At the intersection of cancer and aging, little is known about treatment burden. We evaluated the association between a geriatric assessment-derived Deficit Accumulation Index (DAI) and patient-reported treatment burden in older adults with early-stage, non-muscle-invasive bladder cancer (NMIBC). METHODS: We conducted a cross-sectional survey of older adults with NMIBC (≥65 years). We calculated DAI using the Cancer and Aging Research Group's geriatric assessment and measured urinary symptoms using the Urogenital Distress Inventory-6 (UDI-6). The primary outcome was Treatment Burden Questionnaire (TBQ) score. A negative binomial regression with LASSO penalty was used to model TBQ. We further conducted qualitative thematic content analysis of responses to an open-ended survey question (\"What has been your Greatest Challenge in managing medical care for your bladder cancer\") and created a joint display with illustrative quotes by DAI category. RESULTS: Among 119 patients, mean age was 78.9 years (SD 7) of whom 56.3% were robust, 30.3% pre-frail, and 13.4% frail. In the multivariable model, DAI and UDI-6 were significantly associated with TBQ. Individuals with DAI above the median (>0.18) had TBQ scores 1.94 times greater than those below (adjusted IRR 1.94, 95% CI 1.33-2.82). Individuals with UDI-6 greater than the median (25) had TBQ scores 1.7 times greater than those below (adjusted IRR 1.70, 95% CI 1.16-2.49). The top 5 themes in the Greatest Challenge question responses were cancer treatments (22.2%), cancer worry (19.2%), urination bother (18.2%), self-management (18.2%), and appointment time (11.1%). CONCLUSIONS: DAI and worsening urinary symptoms were associated with higher treatment burden in older adults with NMIBC. These data highlight the need for a holistic approach that reconciles the burden from aging-related conditions with that resulting from cancer treatment.","journal":"Journal of the American Geriatrics Society","year":2023,"id":353301,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":8,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9602,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1100030,"name":"Katie Frank","orcid":null,"position":1,"is_corresponding":false},{"id":741685,"name":"Alicia Johns","orcid":null,"position":2,"is_corresponding":false},{"id":1100031,"name":"Kirstin Rabinowitz","orcid":null,"position":3,"is_corresponding":false},{"id":1100032,"name":"John Danella","orcid":null,"position":4,"is_corresponding":false},{"id":231921,"name":"H. Lester Kirchner","orcid":"0000-0002-2557-6749","position":5,"is_corresponding":false},{"id":543898,"name":"Matthew E. Nielsen","orcid":"0000-0002-0388-1187","position":6,"is_corresponding":false},{"id":379088,"name":"Carmit K. McMullen","orcid":"0000-0001-9445-6591","position":7,"is_corresponding":false},{"id":513335,"name":"Terrence E. Murphy","orcid":"0000-0002-9649-517X","position":8,"is_corresponding":false},{"id":362880,"name":"Harvey Jay Cohen","orcid":null,"position":9,"is_corresponding":false},{"id":379087,"name":"Tullika Garg","orcid":"0000-0003-2679-7460","position":0,"is_corresponding":true}],"reference_count":54,"raw_metadata":null,"created_at":"2026-07-19T01:12:58.542950Z","pmid":"37974546","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":[]}