Dr. Lund has disclosed that her spouse is employed by GlaxoSmithKline. The remaining authors have disclosed that they have no financial interests, arrangements, affiliations, or commercial interests with the manufacturers of any products discussed in this article or their competitors. Funding for this study was provided by the University Cancer Research Fund (UCRF) of the Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill; Breast Cancer Research Foundation, New York, NY (H.B.M.); John A. Hartford Centers of Excellence in Geriatric Medicine and Training Scholar (E.J.G.); UNC Oncology Clinical Translational Research Training Program (5K12CA120780-08) (G.R.W. and J.L.L.); and NCI of the NIH under Award Number (R25CA116339) (M.P.). Work on this study was supported by the Integrated Cancer Information and Surveillance System (ICISS), UNC Lineberger Comprehensive Cancer Center, with funding provided by the UCRF via the State of North Carolina.
Rockwood K, Mitnitski A, Song X et al.. Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. J Am Geriatr Soc 2006;54:975–979.
Song X, Mitnitski A, Rockwood K. Prevalence and 10-year outcomes of frailty in older adults in relation to deficit accumulation. J Am Geriatr Soc 2010;58:681–687.
Fried LP, Tangen CM, Walston J et al.. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146–156.
Saum KU, Dieffenbach AK, Muller H et al.. Frailty prevalence and 10-year survival in community-dwelling older adults: results from the ESTHER cohort study. Eur J Epidemiol 2014;29:171–179.
Mitnitski AB, Mogilner AJ, MacKnight C et al.. The mortality rate as a function of accumulated deficits in a frailty index. Mech Ageing Dev 2002;123:1457–1460.
Walter LC, Covinsky KE. Cancer screening in elderly patients: a framework for individualized decision making. JAMA 2001;285:2750–2756.
Repetto L, Fratino L, Audisio RA et al.. Comprehensive geriatric assessment adds information to Eastern Cooperative Oncology Group performance status in elderly cancer patients: an Italian Group for Geriatric Oncology study. J Clin Oncol 2002;20:494–502.
Jolly TA, Deal AM, Nyrop KA et al.. Geriatric assessment-identified deficits in older cancer patients with normal performance status. Oncologist 2015;20:379–385.
Smith BD, Smith GL, Hurria A et al.. Future of cancer incidence in the United States: burdens upon an aging, changing nation. J Clin Oncol 2009;27:2758–2765.
Cigolle CT, Ofstedal MB, Tian Z et al.. Comparing models of frailty: the Health and Retirement Study. J Am Geriatr Soc 2009;57:830–839.
Rockwood K, Andrew M, Mitnitski A. A comparison of two approaches to measuring frailty in elderly people. J Gerontol A Biol Sci Med Sci 2007;62:738–743.
Hurria A, Gupta S, Zauderer M et al.. Developing a cancer-specific geriatric assessment: a feasibility study. Cancer 2005;104:1998–2005.
Extermann M, Aapro M, Bernabei R et al.. Use of comprehensive geriatric assessment in older cancer patients: recommendations from the task force on CGA of the International Society of Geriatric Oncology (SIOG). Crit Rev Oncol Hematol 2005;55:241–252.
Dotan E, Walter LC, Baumgartner J et al.. NCCN Clinical Practice Guidelines in Oncology: Older Adult Oncology. Version 2.2017. Accessed June 2, 2017. To view the most recent version of these guidelines, visit NCCN.org.
Hurria A, Togawa K, Mohile SG et al.. Predicting chemotherapy toxicity in older adults with cancer: a prospective multicenter study. J Clin Oncol 2011;29:3457–3465.
Extermann M, Boler I, Reich RR et al.. Predicting the risk of chemotherapy toxicity in older patients: the Chemotherapy Risk Assessment Scale for High-Age Patients (CRASH) score. Cancer 2012;118:3377–3386.
Williams GR, Deal AM, Jolly TA et al.. Feasibility of geriatric assessment in community oncology clinics. J Geriatr Oncol 2014;5:245–251.
Hurria A, Cirrincione CT, Muss HB et al.. Implementing a geriatric assessment in cooperative group clinical cancer trials: CALGB 360401. J Clin Oncol 2011;29:1290–1296.
Podsiadlo D, Richardson S. The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991;39:142–148.
Katzman R, Brown T, Fuld P et al.. Validation of a short Orientation-Memory-Concentration test of cognitive impairment. Am J Psychiatry 1983;140:734–739.
Bylow K, Hemmerich J, Mohile SG et al.. Obese frailty, physical performance deficits, and falls in older men with biochemical recurrence of prostate cancer on androgen deprivation therapy: a case-control study. Urology 2011;77:934–940.
Clough-Gorr KM, Stuck AE, Thwin SS et al.. Older breast cancer survivors: geriatric assessment domains are associated with poor tolerance of treatment adverse effects and predict mortality over 7 years of follow-up. J Clin Oncol 2010;28:380–386.
Puts MT, Monette J, Girre V et al.. Are frailty markers useful for predicting treatment toxicity and mortality in older newly diagnosed cancer patients? Results from a prospective pilot study. Crit Rev Oncol Hematol 2011;78:138–149.
Cohen HJ, Smith D, Sun CL et al.. Frailty as determined by a comprehensive geriatric assessment-derived deficit-accumulation index in older patients with cancer who receive chemotherapy. Cancer 2016;122:3865–3872.
Handforth C, Clegg A, Young C et al.. The prevalence and outcomes of frailty in older cancer patients: a systematic review. Ann Oncol 2015;26:1091–1101.
Clough-Gorr KM, Thwin SS, Stuck AE et al.. Examining five- and ten-year survival in older women with breast cancer using cancer-specific geriatric assessment. Eur J Cancer 2012;48:805–812.
Courtney-Brooks M, Tellawi AR, Scalici J et al.. Frailty: an outcome predictor for elderly gynecologic oncology patients. Gynecol Oncol 2012;126:20–24.
Tan KY, Kawamura YJ, Tokomitsu A et al.. Assessment for frailty is useful for predicting morbidity in elderly patients undergoing colorectal cancer resection whose comorbidities are already optimized. Am J Surg 2012;204:139–143.
Kristjansson SR, Nesbakken A, Jordhoy MS et al.. Comprehensive geriatric assessment can predict complications in elderly patients after elective surgery for colorectal cancer: a prospective observational cohort study. Crit Rev Oncol Hematol 2010;76:208–217.
Chappidi MR, Kates M, Patel HD et al.. Frailty as a marker of adverse outcomes in patients with bladder cancer undergoing radical cystectomy. Urol Oncol 2016;34:256.e1–6.
Choi JY, Yoon SJ, Kim SW et al.. Prediction of postoperative complications using multidimensional frailty score in older female cancer patients with American Society of Anesthesiologists physical status class 1 or 2. J Am Coll Surg 2015;221:652–660.e2.
Lascano D, Pak JS, Kates M et al.. Validation of a frailty index in patients undergoing curative surgery for urologic malignancy and comparison with other risk stratification tools. Urol Oncol 2015;33:426.e1–12.
Tegels JJ, de Maat MF, Hulsewe KW et al.. Value of geriatric frailty and nutritional status assessment in predicting postoperative mortality in gastric cancer surgery. J Gastrointest Surg 2014;18:439–445; discussion 445–446.
Revenig LM, Canter DJ, Kim S et al.. Report of a simplified frailty score predictive of short-term postoperative morbidity and mortality. J Am Coll Surg 2015;220:904–911.e1.
Bandeen-Roche K, Seplaki CL, Huang J et al.. Frailty in older adults: a nationally representative profile in the United States. J Gerontol A Biol Sci Med Sci 2015;70:1427–1434.