Frailty & Falls in Community Dwelling Elderly Cancer Survivors Sandra Spoelstra, PhD, MSN, RN 1 ; Barbara Given, PhD, RN, FAAN 1 ; Charles Given, PhD 3 ; Alla Sikorskii, PhD 2; Debra Schutte, PhD, RN 1. Affiliations: Michigan State University of Nursing, 1 College of Nursing, 2 Department of Statistics, 3 College of Human Medicine. Source: Spoelstra, Spoelstra, S. (2010). Falls, fall sequelae, and healthcare use in community dwelling elderly with a history of cancer. A doctoral dissertation. Michigan State University College of Nursing, East Lansing, MI. Problem Statement Cancer survivors are diagnosed at an older age, with treatment often complicated by comorbidities which may exacerbate functional decline leading to frailty & falls. Purposes. To examine the effect of cancer diagnosis on frailty (ADLs, cognition, depression, weight loss, vision & comorbidities); & differences in falls by site, stage, or cancer treatment. Hypotheses. Elderly cancer survivors experience the influence of the disease or treatment of cancer, & have increased frailty & falls. Design & Methodology  Longitudinal retrospective secondary cohort study  A comparison of 9,481 community dwelling elderly age >65  8,617 without Cancer & 864 with Cancer  Minimum Data Set-Home Care, claims files, & CA Registry.  Home & Community Based Waiver Program in State of Michigan. Descriptive & GEE models compared those with & without cancer. Results Cancer: 64% solid tumors; 49% Stage III-IV. Falls: cancer 33% (n=273); non-cancer 30% (n=2790) ADL: cancer 13.23; non-cancer (range 0-52) summed score Short-term memory : cancer 46% (n=395); non-cancer 52% (n=4471) Daily pain: cancer 56% (n=466); non-cancer 58% (n=4598) Weight loss: cancer 16% (n=141); non-cancer 7% (n=576) Comorbidities: 90% with 1; & 36% with >2 comorbidities Conclusion A higher frequency of falls was found in elderly cancer survivors. No difference was found in frailty. Nursing & Research Implications Nurses caring for cancer survivors need to be aware that fall risk is prevalent & conduct fall risk assessments followed by fall prevention interventions. Nurses need to incorporate fall prevention interventions in a ‘ Cancer Survivors Care Plan ’. Replication of this study examining frailty in a data set with more refined measures & a broader range in variation of frailty factors to better understand if frailty differ in cancer survivors when compared to those without cancer. Examining fall patterns in those with cancer compared to other chronic conditions may also be of interest. CA survivors falls compared to those without CA Odds Ratio95% Confidence Interval Cancer vs. no-cancer Weight loss vs. none Short-term memory recall problems vs. none/some Pain daily versus none/some Antidepressants vs. none Male versus Female Comorbidities vs. none White vs. African American Results 77 years old, 62% Female, 74% White, 24% African American. GEE Modeling: Falls occurred at a higher rate ( p =.03) in cancer survivors. No associations were found ( p >.05) between frailty & cancer by stage/site & falls. -A synthesis of: The Life Course Aging Model (Elders, 1985) & The Health Related Quality of Life Model (Ferrans, 2005). Conceptual Framework Environment: housing, caregivers, time alone during day Cancer: -Type -Stage -Date of Diagnosis Age, Sex, Race, Marital Status -Falls -Fractures -ER Use -Hospital Use -Nursing Home Placement -Medications -Cancer Treatment CognitionComorbidity ADLs Funding sources: NRSA Grant number 1 F31 NR , State of Michigan Nurse Corp, Blue Cross & Blue Shield & MSU Graduate School Dissertation Awards.