Abstract
Glioblastomas are the most common primary malignant brain tumor in adults. Subject age is a strong prognostic factor for survival. We performed a co-morbidity analysis of younger vs. older (greater than 65 years) adults with grade IV gliomas (GIV) to understand inherent differences that vary with subject age. Electronic health records for 1,208 GIV patients were collected at a single center between 1/1/2000 and 9/8/2021 and used to construct a multivariable time-dependent cox model that examined intra-cohort hazards associated with 33 measures of co-morbidity and tumor related symptoms. The date of GIV diagnosis was identified as the start time, and subject death was used to define event time. Patients that were alive or lost to follow-up were censored at the last recorded date. Survival time was calculated as the difference between diagnosis date and event time or censorship. GIV was stratified by IDH and MGMT promoter methylation status when available. Younger patients experienced a greater hazard with: limitations to movement (1.88 [1.46, 2.43] ****), gait (1.72 [1.17, 2.52] **), weakness (1.96 [1.26, 3.06] **), seizures (1.28 [1.04, 1.58] *), epilepsy (1.47 [1.09, 1.99] *), and anxiety disorders (2.37 [1.44, 3.92], **). Older GIV patients experienced an increased hazard with: confusion and altered mental status (4.3 [2.08, 8.89], ****). Both age groups experienced increases with eye/visual systems and plegia. These data indicate novel comorbid enrichments varying by subject age that, from a mechanistic perspective, may be used to better understand why older adults with GIV survive significantly less than younger counterparts.