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Peer-reviewedCC BY-NC-ND 4.0Journal of the American Geriatrics Society

Mechanisms of Benefit in Geriatric Assessment (GA): Approach‐Oriented Coping Mediates Outcomes of a GA‐Guided Supportive Care Intervention (GAIN‐S)

  • Cristiane Decat Bergerot1
  • Paulo Gustavo Bergerot1
  • Marianne Razavi2
  • Marcos Vinicius da Silva França3
  • Jose Adolfo Cerveira1
  • William Hiromi Fuzita1
  • Errol J. Philip4
  • Carlos Gil Moreira Ferreira1
  • Marco Murilo Buso1
  • Ryan Nipp5
  • Areej El‐Jawahri6
  • Enrique Soto‐Perez‐de‐Celis7
1 more authors
  • William Dale2
7 affiliations
  1. 1Oncoclinicas&Co ‐ Medica Scientia Innovation Research (MEDSIR) Sao Paulo Brazil
  2. 2Department of Supportive Care Medicine City of Hope National Medical Center Duarte California USA
  3. 3Rede D'OR Brasilia Brazil
  4. 4University of California Los Angeles Los Angeles California USA
  5. 5Section of Hematology/Oncology, Department of Medicine The University of Oklahoma Health Oklahoma City Oklahoma USA
  6. 6Massachusetts General Hospital Boston Massachusetts USA
  7. 7Division of Medical Oncology University of Colorado Anschutz Medical Campus Denver Colorado USA
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Abstract

Background: Older adults with metastatic cancer often experience declines in physical function, emotional well‐being, and quality of life (QOL). Geriatric assessment and management (GAM) have shown promise in addressing these challenges, but underlying mechanisms remain unclear. This study explored coping strategies as potential mediators for improvements in physical function, depression, and QOL.

Methods: For this secondary analysis of a randomized controlled trial, older adults (≥ 65 years) with metastatic cancer across multiple cancer centers in Brazil were recruited (n = 77). Participants were randomized 1:1 to receive either usual care (UC; n = 38) or a tailored multidisciplinary telehealth GAM intervention (GAIN‐S; n = 39). Outcomes were assessed at baseline and 3 months, including Instrumental Activities of Daily Living (IADL), geriatric depressive symptoms (GDS), and Functional Assessment Cancer Therapy—General (FACT‐G). Coping was assessed using the Brief COPE. Mediation analyses examined whether coping strategies explained intervention effects.

Results: Among 77 patients (mean age = 74 years; 56% female), most were married (61%), and well educated (50% ≥ college degree). The most common cancer types were genitourinary (29%), breast (24%), and gastrointestinal (22%) cancers. Mediation analyses revealed that improvements in approach‐oriented coping mediated the effects of the GAM intervention on depressive symptoms (31%) and QOL (18%). Avoidant coping did not significantly mediate any outcomes.

Conclusions: In the GAIN‐S trial, improvements in approach‐oriented coping partially mediated improvements in QOL and depressive symptoms outcomes among older adults with metastatic cancer. Enhancing adaptive coping could plays a key role in the care of older adults with cancer, and our results offer a novel mechanistic insight for GAM gains.

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Cite

BibTeXRIS
BibTeX
@article{bergerot2026mechanisms,
  title = {{Mechanisms of Benefit in Geriatric Assessment (GA): Approach‐Oriented Coping Mediates Outcomes of a GA‐Guided Supportive Care Intervention (GAIN‐S)}},
  author = {Cristiane Decat Bergerot and Paulo Gustavo Bergerot and Marianne Razavi and Marcos Vinicius da Silva França and Jose Adolfo Cerveira and William Hiromi Fuzita and Errol J. Philip and Carlos Gil Moreira Ferreira and Marco Murilo Buso and Ryan Nipp and Areej El‐Jawahri and Enrique Soto‐Perez‐de‐Celis and William Dale},
  journal = {Journal of the American Geriatrics Society},
  year = {2026},
  month = aug,
  doi = {10.1111/jgs.70644},
  url = {https://doi.org/10.1111/jgs.70644},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Mechanisms of Benefit in Geriatric Assessment (GA): Approach‐Oriented Coping Mediates Outcomes of a GA‐Guided Supportive Care Intervention (GAIN‐S)
AU  - Cristiane Decat Bergerot
AU  - Paulo Gustavo Bergerot
AU  - Marianne Razavi
AU  - Marcos Vinicius da Silva França
AU  - Jose Adolfo Cerveira
AU  - William Hiromi Fuzita
AU  - Errol J. Philip
AU  - Carlos Gil Moreira Ferreira
AU  - Marco Murilo Buso
AU  - Ryan Nipp
AU  - Areej El‐Jawahri
AU  - Enrique Soto‐Perez‐de‐Celis
AU  - William Dale
PY  - 2026
DA  - 2026/08/24
JO  - Journal of the American Geriatrics Society
DO  - 10.1111/jgs.70644
UR  - https://doi.org/10.1111/jgs.70644
AB  - Background: Older adults with metastatic cancer often experience declines in physical function, emotional well‐being, and quality of life (QOL). Geriatric assessment and management (GAM) have shown promise in addressing these challenges, but underlying mechanisms remain unclear. This study explored coping strategies as potential mediators for improvements in physical function, depression, and QOL.  Methods: For this secondary analysis of a randomized controlled trial, older adults (≥ 65 years) with metastatic cancer across multiple cancer centers in Brazil were recruited (n = 77). Participants were randomized 1:1 to receive either usual care (UC; n = 38) or a tailored multidisciplinary telehealth GAM intervention (GAIN‐S; n = 39). Outcomes were assessed at baseline and 3 months, including Instrumental Activities of Daily Living (IADL), geriatric depressive symptoms (GDS), and Functional Assessment Cancer Therapy—General (FACT‐G). Coping was assessed using the Brief COPE. Mediation analyses examined whether coping strategies explained intervention effects.  Results: Among 77 patients (mean age = 74 years; 56% female), most were married (61%), and well educated (50% ≥ college degree). The most common cancer types were genitourinary (29%), breast (24%), and gastrointestinal (22%) cancers. Mediation analyses revealed that improvements in approach‐oriented coping mediated the effects of the GAM intervention on depressive symptoms (31%) and QOL (18%). Avoidant coping did not significantly mediate any outcomes.  Conclusions: In the GAIN‐S trial, improvements in approach‐oriented coping partially mediated improvements in QOL and depressive symptoms outcomes among older adults with metastatic cancer. Enhancing adaptive coping could plays a key role in the care of older adults with cancer, and our results offer a novel mechanistic insight for GAM gains.
SN  - 0002-8614
SN  - 1532-5415
ER  -