A new study links changes in frailty, a measure of decreased physiological capacity that leads to fatigue, slow walking, muscle weakness, physical inactivity, and weight loss, to five-year survival rates in older women with breast cancer.

These findings suggest that managing frailty during chemotherapy could improve outcomes.

Published in JAMA Network Open and entitled “Frailty Trajectories Following Adjuvant Chemotherapy and Mortality in Older Women With Breast Cancer,” the study found that 4.5% of women out of a cohort of 20,292 women aged 65 and older with stage I to stage III breast cancer experienced nonresilient frailty trajectories — a decline in physiologic reserve — following chemotherapy initiation.

These women had significantly worse survival outcomes compared to those with more stable or improving frailty trajectories.

Despite representing a small percentage of the cohort, the group of nonresilient women had notably higher mortality rates.

The study also found that those who maintained their strength or recovered from a temporary decline had better survival rates.

However, while tracking frailty changes over time helped researchers understand overall survival trends in groups of patients, it was less useful for predicting an individual’s risk of death.

The study also highlighted the need for further research on whether frailty changes can predict other important health outcomes, like falls or hospitalisations.

It suggested that patients at higher risk — such as those with preexisting health conditions — might benefit from targeted interventions like nutrition support, physical activity, and better management of treatment side effects.

Researchers emphasised the importance of tracking frailty throughout cancer treatment to improve care and outcomes for older patients.

“Our research demonstrates that frailty is not a static condition but can change over time, especially during cancer treatment. By closely monitoring frailty trajectories, health care providers can better identify patients at increased risk and implement timely interventions to improve survival outcomes,” said Dae Hyun Kim, MD, MPH, ScD, associate scientist and founder of the Frailty Research Programme at the Hinda and Arthur Marcus Institute for Ageing Research at Hebrew SeniorLife.

Source: Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research