Authors aim to evaluate frailty across multiple domains and examine its association with prostate cancer (PCa)-specific health-related quality of life (HRQoL) in low-income, uninsured men enrolled in the Improving Access, Counseling and Treatment for Californians with Prostate Cancer (IMPACT) Program. The RAND SF-12v2 (12-Item Short Form Survey, version 2), California Health Interview Survey (CHIS), and Total Illness Burden Index for Prostate Cancer (TIBI-CaP) were used. Authors analyzed associations between frailty status and PCI domains using multivariable logistic regression.

Findings: Among 342 participants, 25% were frail, 46% were prefrail, and 29% were nonfrail. Across all PCI domains, PCa-specific HRQoL was significantly worse in the prefrail and frail groups. Sexual function demonstrated the greatest impairment. After covariate adjustment, both prefrailty and frailty remained independently associated with worse PCa-specific HRQoL. Frailty is significantly associated with poorer PCa-specific HRQoL in low-income, uninsured men. These findings suggest that comprehensive frailty assessment has a role in guiding personalized interventions to improve genitourinary HRQoL outcomes in men with PCa.