{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:06:58Z","timestamp":1790950018965,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,11,16]],"date-time":"2023-11-16T00:00:00Z","timestamp":1700092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR002014"],"award-info":[{"award-number":["UL1 TR002014"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG021342"],"award-info":[{"award-number":["P30AG021342"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["P30AG028716"],"award-info":[{"award-number":["P30AG028716"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R03AG064382"],"award-info":[{"award-number":["R03AG064382"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["agsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>When a person's workload of healthcare exceeds their resources, they experience treatment burden. At the intersection of cancer and aging, little is known about treatment burden. We evaluated the association between a geriatric assessment\u2010derived Deficit Accumulation Index (DAI) and patient\u2010reported treatment burden in older adults with early\u2010stage, non\u2010muscle\u2010invasive bladder cancer (NMIBC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross\u2010sectional survey of older adults with NMIBC (\u226565\u2009years). We calculated DAI using the Cancer and Aging Research Group's geriatric assessment and measured urinary symptoms using the Urogenital Distress Inventory\u20106 (UDI\u20106). The primary outcome was Treatment Burden Questionnaire (TBQ) score. A negative binomial regression with LASSO penalty was used to model TBQ. We further conducted qualitative thematic content analysis of responses to an open\u2010ended survey question (\u201cWhat has been your Greatest Challenge in managing medical care for your bladder cancer\u201d) and created a joint display with illustrative quotes by DAI category.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 119 patients, mean age was 78.9\u2009years (SD 7) of whom 56.3% were robust, 30.3% pre\u2010frail, and 13.4% frail. In the multivariable model, DAI and UDI\u20106 were significantly associated with TBQ. Individuals with DAI above the median (&gt;0.18) had TBQ scores 1.94 times greater than those below (adjusted IRR 1.94, 95% CI 1.33\u20132.82). Individuals with UDI\u20106 greater than the median (25) had TBQ scores 1.7 times greater than those below (adjusted IRR 1.70, 95% CI 1.16\u20132.49). The top 5 themes in the Greatest Challenge question responses were cancer treatments (22.2%), cancer worry (19.2%), urination bother (18.2%), self\u2010management (18.2%), and appointment time (11.1%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DAI and worsening urinary symptoms were associated with higher treatment burden in older adults with NMIBC. These data highlight the need for a holistic approach that reconciles the burden from aging\u2010related conditions with that resulting from cancer treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.18676","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T03:52:16Z","timestamp":1700193136000},"page":"490-502","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Geriatric assessment\u2010derived deficit accumulation and patient\u2010reported treatment burden in older adults with bladder cancer"],"prefix":"10.1111","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2679-7460","authenticated-orcid":false,"given":"Tullika","family":"Garg","sequence":"first","affiliation":[{"name":"Department of Urology Penn State Health Milton S. Hershey Medical Center  Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie","family":"Frank","sequence":"additional","affiliation":[{"name":"Biostatistics Core Geisinger  Danville Pennsylvania USA"},{"name":"Department of Population Health Sciences Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Johns","sequence":"additional","affiliation":[{"name":"Biostatistics Core Geisinger  Danville Pennsylvania USA"},{"name":"Department of Population Health Sciences Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirstin","family":"Rabinowitz","sequence":"additional","affiliation":[{"name":"Investigator Initiated Research Operations Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John F.","family":"Danella","sequence":"additional","affiliation":[{"name":"Department of Urology Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. Lester","family":"Kirchner","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences Geisinger  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Urology University of North Carolina at Chapel Hill School of Medicine  Chapel Hill North Carolina USA"},{"name":"Departments of Epidemiology and Health Policy &amp; Management University of North Carolina at Chapel Hill, Gillings School of Global Public Health  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmit K.","family":"McMullen","sequence":"additional","affiliation":[{"name":"Center for Health Research Kaiser Permanente Northwest  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9649-517X","authenticated-orcid":false,"given":"Terrence 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