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Instrumental activities of daily living in older patients with metastatic prostate cancer: results from the meet-URO network ADHERE prospective study

Lookup NU author(s): Dr Pasquale RescignoORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© The Author(s) 2024.Instrumental activities of daily living (IADL) are significant health indicators closely related to executive functions and able to detect mild cognitive impairment. A decline in IADL usually precedes ADL limitation, including taking medications, and may therefore predict a cognitive decline. We aimed to investigate the association of patients’ IADL score with other clinical factors, with a particular focus on the presence of a caregiver, and the impact on adherence to androgen receptor pathway inhibitors (ARPIs) and survival outcomes within the Meet-URO 5—ADHERE study. It was a large prospective multicentre observational cohort study monitoring adherence to ARPIs in 234 metastatic castrate-resistant PC (mCRPC) patients aged ≥ 70. We observed an association between impaired IADL and lower geriatric G8 scores (p < 0.01), and lower adherence to ARPIs whether assessed by pill counting (p = 0.01) or self-reported by the patient himself (p = 0.03). The combination of an IADL < 6 and the absence of a caregiver resulted in a significantly high risk of non-adherence to the ARPIs at the multivariable analysis (HR 9.23, 95% confidence interval 2.28–37.43, p = 0.01). IADL alongside the geriatric G8 scales represent essential tools to identify frail and less auto-sufficient patients who are extremely vulnerable particularly if not supported by a caregiver and have the highest risk of nonadherence to ARPIs.

Publication metadata

Author(s): Fratino L, Polesel J, Giunta EF, Maruzzo M, Buti S, Hassan MA, Basso U, Rebuzzi SE, De Giorgi U, Cinausero M, Lipari H, Gamba T, Bimbatti D, Dri A, Ermacora P, Vignani F, Fornarini G, Rescigno P, Banna GL

Publication type: Article

Publication status: Published

Journal: Scientific Reports

Year: 2024

Volume: 14

Issue: 1

Online publication date: 28/02/2024

Acceptance date: 02/02/2024

Date deposited: 07/11/2024

ISSN (electronic): 2045-2322

Publisher: Nature Research

URL: https://doi.org/10.1038/s41598-024-53581-4

DOI: 10.1038/s41598-024-53581-4

Data Access Statement: The datasets used and/or analysed during the current study available from the corresponding author on reasonable request.

PubMed id: 38418470

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