A comparison of three different approaches to defining frailty in older patients with multiple myeloma

Ariel Isaacs, Mark Fiala, Sascha Tuchman, Tanya M. Wildes

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Objectives: As the aging population grows, interest in applying the concept of frailty to older adults with cancer has increased. This study examines the prevalence of frailty in older patients with multiple myeloma using three frailty models. Methods: In this secondary analysis of a prospective cohort study, 40 adults aged ≥65 with myeloma completed the Cancer and Aging Research Group geriatric assessment within three months of initial diagnosis. Geriatric assessment data was used to categorize patients' frailty status according to three indices: The International Myeloma Working Group (IMWG) Frailty Index, the Revised Myeloma Comorbidity Index (R-MCI), and the Carolina Frailty Index (CFI). Agreement between the indices was examined using Cohen's kappa. Results: Twenty-eight patients were classified as frail by at least one of the models. However, only slight agreement exists on the classification of frailty among the indices, with little concordance among the models (Kappa 0.03–0.12). Only three patients were categorized as frail by all three models. Conclusion: In a cohort of 40 older adults with newly diagnosed multiple myeloma, three frailty indices have differing approaches to operationalizing frailty resulting, in different patients being categorized as frail. Little agreement existed between the models. Further studies are needed to explore the utility of these models in predicting treatment toxicity and prognosis.

Original languageEnglish
Pages (from-to)311-315
Number of pages5
JournalJournal of Geriatric Oncology
Issue number2
StatePublished - Mar 2020


  • Elderly
  • Frailty
  • Geriatric assessment
  • Multiple myeloma
  • Survival


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