# Predicting Functional Decline and Clinical Outcomes in Newly Diagnosed Older Patients with Localized Bladder Cancer

> **NIH NIH R03** · UNIVERSITY OF WASHINGTON · 2022 · $157,481

## Abstract

PROJECT SUMMARY/ABSTRACT:
Older patients with cancer are disproportionately perceived as unfit for aggressive therapies, resulting in
significantly lower rates of definitive cancer care and poor outcomes. We lack validated tools to reliably predict
personalized risks of adverse treatment-related events and salient outcomes for older patients such as functional
decline. While guidelines advocate for widespread adoption of Geriatric Assessments (GAs) to quantify
multidimensional vulnerabilities prior to treatment decision-making in older patients with cancer, clinical adoption
is low related to a dearth of data evaluating the ability of GAs in clinical practice to discriminate those at risk for
functional decline, adverse clinical and oncologic outcomes. Furthermore, traditional GAs do not include
validated metrics of muscle mass that independently predict clinical and oncologic outcomes. Bladder cancer is
an ideal health condition in which to evaluate and develop personalized geriatric oncology risk stratification tools,
given median age at diagnosis of 73 years, a high baseline prevalence of comorbidities, substantial risk of
treatment-associated adverse events, and universal lethality if untreated. Our objective is to quantify functional
decline in patients with newly diagnosed bladder cancer, and to develop prediction models incorporating GA-
based frailty and muscle metrics for the outcomes of functional decline, treatment-associated morbidity and
mortality. The Specific Aims are: (1A) To characterize prevalence and predictors of functional decline in older
adults with newly diagnosed bladder cancer, (1B) to determine if baseline frailty and muscle metrics predict
functional decline, and (2) To evaluate associations frailty, muscle metrics, and treatment-associated outcomes
(i.e., adverse events, survival) in older adults with localized high-risk bladder cancer. To achieve Aim 1, baseline
functional status will be compared with a 3-month assessment in a prospective newly diagnosed older bladder
cancer cohort (N=250) undergoing a pretreatment GA-based frailty self-assessment and muscle metrics and a
predictive model will be developed. For Aim 2, we will construct multivariable models for treatment-associated
adverse events, postoperative complications, and mortality incorporating GA-based frailty and muscle metrics
from a robust bladder cancer registry. This innovative study advances risk stratification by incorporating validated
GA tools augmented with robust body composition data. This work is significant: it will be the first study to
characterize risk factors for functional decline in older bladder cancer patients, while addressing the acute need
to validate rigorous personalized risk stratification tools incorporating geriatric conditions to inform treatment
decisions, ensuring alignment with patient priorities. This work will directly translate to improvements in outcomes
of older patients with cancer and extrapolate to other malignancies...

## Key facts

- **NIH application ID:** 10517212
- **Project number:** 1R03AG073990-01A1
- **Recipient organization:** UNIVERSITY OF WASHINGTON
- **Principal Investigator:** Sarah Patricia Psutka
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $157,481
- **Award type:** 1
- **Project period:** 2022-09-15 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10517212

## Citation

> US National Institutes of Health, RePORTER application 10517212, Predicting Functional Decline and Clinical Outcomes in Newly Diagnosed Older Patients with Localized Bladder Cancer (1R03AG073990-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10517212. Licensed CC0.

---

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