# Improving the prediction of life expectancy among older adults with advanced cancer using geriatric assessment

> **NIH NIH R21** · UNIV OF NORTH CAROLINA CHAPEL HILL · 2021 · $207,610

## Abstract

ABSTRACT
Predicting life expectancy in older adults with advanced (stage IV or incurable stage III) cancers is challenging
due to heterogeneity in the presence of chronic conditions and geriatric syndromes, which independently
increase the risk of death. Accurate prediction and communication of life expectancy is a key component of
shared decision-making for older adults with advanced cancers and their providers. However, evidence shows
that oncologists tend to overestimate life expectancy in older adults with advanced cancer. Standard tools
currently available for predicting life expectancy perform poorly in this population. The geriatric assessment is a
set of validated, patient-reported and objective measures to assess comorbidity, functional status, physical
performance, cognitive status, psychological status, nutritional status, polypharmacy, and social support, and
has potential to improve prediction of life expectancy for older adults with advanced cancer. Yet, no studies
have explicitly sought to harness information captured from the geriatric assessment to develop a clinical
prediction model for life expectancy in older adults with advanced cancers. This study will leverage detailed
information from geriatric assessment and advanced statistical methods to develop and validate a new life
expectancy prediction model for older adults (age 70 and over) with advanced cancer. We will then evaluate
the extent of improvement in predictive performance of this new GA model compared with oncologists’ self-
reported estimates of life expectancy and a model based on routinely collected clinical data (age,
comorbidities, and performance status). To achieve these aims, we will link the most up-to-date vital status
data from the Medicare program with detailed geriatric assessments for >800 patients aged 70 years and older
with advanced cancer and their oncologists participating in two community-based, cluster-randomized trials.
Our multidisciplinary study team has the requisite expertise in data linkage, predictive modeling, geriatric
oncology, and palliative care to conduct this research and translate our findings into meaningful advances for
this vulnerable population. Our work will lead to the develop of a clinical prediction tool that can be used in
future experimental work to test whether the life expectancy prediction model based on geriatric assessment
can improve patient-provider communication about prognosis and the delivery of high-quality, patient-centered
cancer care.

## Key facts

- **NIH application ID:** 10216542
- **Project number:** 1R21AG068965-01A1
- **Recipient organization:** UNIV OF NORTH CAROLINA CHAPEL HILL
- **Principal Investigator:** Jennifer Lund
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $207,610
- **Award type:** 1
- **Project period:** 2021-05-01 → 2023-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10216542

## Citation

> US National Institutes of Health, RePORTER application 10216542, Improving the prediction of life expectancy among older adults with advanced cancer using geriatric assessment (1R21AG068965-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10216542. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*