Racial disparities in longitudinal frailty state transitions among older cancer survivors

Abstract

Introduction

Black older patients with cancer are at high risk of frailty during cancer treatment, yet racial disparities in long-term frailty state transitions during the survivorship phase are understudied.

Materials and Methods

We conducted a longitudinal analysis of older cancer survivors (≥65 years) using rounds 1–9 (2011–2019) of the National Health and Aging Trends Study. A multistate Markov model assessed one-year transitions across Fried frailty phenotypes states (robust, prefrail, frail) and death, stratified by self-reported race (Black vs. non-Black).

Results

Among 1303 survivors, 55 % were female, 24 % Black, and 76 % non-Black. Black survivors were less likely to remain robust (50 % vs. 57 %), more likely to stay frail (46 % vs. 39 %), more likely to die, and more likely to transition to poorer frailty states (e.g., robust to prefrail or frail) than non-Black survivors.

Discussion

Black older cancer survivors experience poorer frailty trajectories than non-Black counterparts, highlighting the need for targeted survivorship care to improve long-term outcomes.