Physical function in older adults with and without a cancer history: Findings from the National Health and Aging Trends Study |
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| Authors: | Nancy M. Gell PhD MPH Myeongjin Bae MS Kushang V. Patel PhD MPH Kathryn Schmitz PhD Kim Dittus MD PhD Michael Toth PhD |
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| Affiliation: | 1. Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, USA;2. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA;3. Division of Hematology and Oncology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA;4. University of Vermont Cancer Center, Burlington, Vermont, USA Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont, USA;5. Department of Medicine, University of Vermont College of Medicine, Burlington, Vermont, USA |
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| Abstract: | Background Previous studies identified physical function limitations in older cancer survivors, but few have included objective measures and most focused on breast and prostate cancer survivors. The current study compared patient-reported and objective physical function measures between older adults with and without a cancer history. Methods Our cross-sectional study used a nationally representative sample of community-dwelling, Medicare beneficiaries from the 2015 National Health and Aging Trends Study (n = 7495). Data collected included patient-reported physical function, including a composite physical capacity score and limitations in strength, mobility, and balance, and objectively measured physical performance metrics, including gait speed, five time sit-to-stand, tandem stand, and grip strength. All analyses were weighted to account for the complex sampling design. Results Thirteen percent of participants (n = 829) reported a history of cancer, of which more than half (51%) reported a diagnosis other than breast or prostate cancer. In models adjusted for demographics and health history, older cancer survivors had lower Short Physical Performance Battery scores (unstandardized beta [B] = −0.36; 95% CI: −0.64, −0.08), slower gait speed (B = −0.03; 95% CI: −0.05, −0.01), reduced grip strength (B = −0.86; 95% CI: −1.44, −0.27), worse patient-reported composite physical capacity (B = −0.43; 95% CI: −0.67, −0.18) and patient-reported upper extremity strength (B = 1.27; 95% CI: 1.07, 1.50) compared to older adults without cancer. Additionally, the burden of physical function limitations was greater in women than in men, which may be explained by cancer type. Conclusions Our results extend studies in breast and prostate cancer to show worse objective and patient-reported physical function outcomes in older adults with a range of cancer types compared to those without a cancer history. Moreover, these burdens seem to disproportionately affect older adult women, underscoring the need for interventions to address functional limitations and prevent further health consequences of cancer and its treatment. |
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| Keywords: | mobility older adults oncology physical capacity physical performance |
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