Distribution of Geriatric 8 screening tool scores in elderly and non-elderly patients with cancer

Introduction: Population aging and increased cancer incidence have made the treatment of cancer in older individuals an increasingly important issue. Geriatric 8 (G8) is a screening tool developed to identify patients who would benefit most from a comprehensive geriatric assessment (GA). Previous G8 studies have involved older patients, but the age-related significance and usefulness of G8 is unknown. In this study, G8 screening was administered to patients who were 30 years of age or over with cancer to examine a G8 score in each 10 years age group and its correlation with other GA tools.

Materials and methods: The study was conducted at Fukuoka University Hospital from January 2020 to March 2022 and enrolled 715 patients aged ≥ 30 years undergoing surgery for primary gastrointestinal cancer or malignant disease. The relationship between age, G8, instrumental activities of daily living (IADL), activities of daily living (ADL), and the Charlson Comorbidity Index (CCI) was investigated.

Results: The median age of the patients was 69 years (34-98 years). Functional disability in ADLs was present in 43 patients (6%) and in IADLs in 72 patients (10.1%). The mean G8 score by age group was 13.7, 13.1, 13.3, 13.3, 12.4, 11.3, and 9.25 for ages 30-39, 40-49, 50-59, 60-69, 70-79, 80-89, and 90-100 years, respectively. For each of the ADL/IADL items, the group with functional disability had significantly lower G8 scores than the group without functional disability (p < 0.001). The relationship between the G8 score and CCI by age group showed that the G8 score decreased as the CCI score increased. Assessments divided into age groups of 65, 70, and 75 years showed significant differences between groups for most ADL/IADL items and G8 scores, even when divided by age 65.

Discussion: G8 scores were lower in patients with ADL/IADL disabilities and decreased with age in both the presence and absence of disabilities. The G8 total score decreased significantly after the age of 70 years. Performing G8 in patients < 65 years of age does not decrease sensitivity; however, the functional decline is so slight that it appears reasonable to restrict G8 screening to patients ≥ 65 years of age.