# Geriatric Assessment with Geriatric-8, Body Weight Loss, and Bioelectrical Impedance Analysis in Older Patients with Lung Cancer: A Single-Center Retrospective Study

## TL;DR

This study explores combining Geriatric-8 scores, weight loss, and bioelectrical impedance to assess frailty in older lung cancer patients.

## Contribution

A new method for geriatric assessment in lung cancer patients using G8, weight loss, and bioelectrical impedance is proposed.

## Key findings

- G8 scores ≤14.0 and 5% weight loss were linked to advanced-stage lung cancer.
- Bioelectrical impedance measures like ECW/TBW correlated with physical function decline and sarcopenia.
- Combining G8, weight loss, and BIA factors improved classification of patient frailty and survival prediction.

## Abstract

There is no standard geriatric assessment (GA) for patients aged ≥65 years with lung cancer (hereafter referred to as patients). This retrospective study evaluated whether GA could be achieved by combining Geriatric-8 (G8) score (G8s), body weight loss (BWL) of more than 5% (5%BWL), and bioelectrical impedance analysis (BIA).

This study included patients who underwent G8 screening, BIA (measuring skeletal muscle mass index [SMI] and extracellular water-to-total body water ratio [ECW/TBW]), and physical function tests before treatment at our hospital between March 1, 2023, and December 31, 2024. Patient clinical records were reviewed to collect baseline data. Statistical analyses were conducted using R (version 4.1.1).

A total of 120 patients were analyzed. We found the following significant associations: G8s ≤14.0 and 5%BWL were associated with advanced-stage disease; G8s >14.0 and SMI ≥cut-off value (CV) with higher body mass index; ECW/TBW ≥0.4 (0.4 ECW/TBW) with aging and poor performance status; 5%BWL with lower maximum lower leg calf circumference (MLLCC); SMI ≥CV with higher maximum handgrip strength (MHGS) and MLLCC; 0.4 ECW/TBW with lower MHGS, gait speed, and five-time sit-to-stand performance. The multivariate analysis confirmed significant associations: G8s ≤14.0 was associated with cancer cachexia; SMI < CV and 0.4 ECW/TBW were associated with sarcopenia, and 0.4 ECW/TBW was associated with physical function decrease, as indicated by a Short Physical Performance Battery score of ≤9. Patients with G8s ≤14.0, 5%BWL, or 0.4 ECW/TBW had shorter survival durations than their respective counterparts. Patients were classified into three frailty categories (none, mild combined with moderate, severe) based on a combination of four factors (G8, BWL, SMI, and ECW/TBW) and had distinct survival curves.

The combination of these four factors offers a simple and objective approach for GA in patients.