Utility of a modified geriatric assessment to identify impairments in adults of all ages with lymphoma: A prospective observational cohort study.

INTRODUCTION

Performance status assessments may overlook important health vulnerabilities in adults with cancer. While geriatric assessment (GA) systematically evaluates multiple domains including physical function, cognition, psychological health, comorbidity, and nutrition, it has been predominantly studied in older adults. We evaluated the prevalence and patterns of GA-identified deficits among adults of all ages initiating systemic therapy for lymphoma.

MATERIALS AND

METHODS

Adults with lymphoma enrolled in a prospective registry at an academic cancer center from 2018 to 2025 completed a modified Cancer and Aging Research Group (CARG) GA at treatment initiation. The assessment included validated measures across eight domains: mobility (Timed Up and Go), falls history, instrumental activities of daily living (IADLs), medication burden, comorbidities, weight loss, cognition (Blessed Orientation-Memory-Concentration test), and psychological health (Mental Health Index-13). Karnofsky Performance Status (KPS) was documented. Prevalence of deficits was compared between adults <65 and ≥ 65 years.

RESULTS

Among 97 participants (mean age 57 years, range 22-84; 39% ≥65 years), 94% had normal KPS (≥80). Despite preserved performance status, 56% had multiple (≥2) GA-identified deficits, and only 21% had zero deficits. The most common deficit was unintentional weight loss (43% overall). Among younger adults (<65 years), substantial proportions reported weight loss (34%), falls (27%), IADL impairment (27%), and anxiety or depression (45%). Most deficits did not differ significantly between age groups, though weight loss, multimorbidity (≥4 comorbidities), and severe polypharmacy (≥10 medications) were more prevalent in older adults.

DISCUSSION: GA reveals high prevalence of health-related deficits across multiple domains in adults with lymphoma regardless of age, despite preserved performance status. These findings support a shift toward needs-based rather than age-based approaches to identify individuals who may benefit from supportive care interventions.