No abstract

The observed inverse relations between physical fitness and hs-CRP and between level of physical activity and sE-selectin in drug-treated, hypertensive sedentary men indicates a beneficial effect of good fitness status as well as activity of low intensity on vessel wall inflammation.

BackgroundThe global population is ageing, and age is an important risk factor for cancer. The median age at diagnosis in Norway is about 70 years, and the number of older patients with cancer is rapidly increasing. The older population exhibit a large variety in general health status, and chronologic age is a poor marker for biologic age. Many older adults live with frailty, a condition characterised by depleted physiological and functional organ reserves leading to increased vulnerability to stressors. Geriatric assessment (GA) is a systematic evaluation of domains where older adults commonly have problems such as comorbidity, polypharmacy, nutritional status, physical function, functional status, and psychosocial function. Performing GA to identify patients' vulnerabilities and reserves is strongly advocated, although seldom applied in oncology practice. Approximately 50% of patients with cancer will need radiotherapy (RT) at some point during the disease trajectory. Older patients may prioritise preserved quality of life (QoL), physical function, and independency over limited survival benefits. However, little is known about how RT influences these outcomes in older patients with cancer. AimWe aimed to investigate the prevalence of age-related health problems and the development in cognitive function, in a cohort of older patients with cancer receiving RT with curative or palliative treatment intent and to assess the impact of age-related health problems on overall survival (OS), global QoL and physical function. MethodsA single centre prospective observational study was conducted including patients ≥65 years referred for curative or palliative RT. Prior to RT, we performed a modified GA (mGA) including comorbidities, medications, nutritional status, basic and instrumental activities of daily living (IADL), mobility, falls, cognition and depressive symptoms using recommended and validated tools. The mGA was repeated at RT completion, and two, eight and sixteen weeks later. At the same time points, patients reported global QoL and physical function (PF) by the European Organisation for Research and Treatment of Cancer Quality of Life Core questionnaire (QLQ-C30). Impairments in each mGA domain were defined based on recommended cut-points. OS was presented by Kaplan Meier plots for groups defined according to number of geriatric impairments and compared using the log-rank test. The

One year of lifestyle intervention reduced the level of sICAM-1 in sedentary, drug-treated hypertensives, in spite of no impact on traditional risk factors. Low dose fluvastatin had no beneficial effect on the measured markers.

Cognitive function can be affected by cancer and/or its treatment, and older patients are at a particular risk. In a prospective observational study including patients ≥65 years referred for radiotherapy (RT), we aimed to investigate the association between patient- and cancer-related factors and cognitive function, as evaluated by the Montreal Cognitive Assessment (MoCA), and sought to identify groups with distinct MoCA trajectories. The MoCA was performed at baseline (T0), RT completion (T1), and 8 (T2) and 16 (T3) weeks later, with scores ranging between 0 and 30 and higher scores indicating better function. Linear regression and growth mixture models were estimated to assess associations and to identify groups with distinct MoCA trajectories, respectively. Among 298 patients with a mean age of 73.6 years (SD 6.3), the baseline mean MoCA score was 24.0 (SD 3.7). Compared to Norwegian norm data, 37.9% had cognitive impairment. Compromised cognition was independently associated with older age, lower education, and physical impairments. Four groups with distinct trajectories were identified: the very poor (6.4%), poor (8.1%), fair (37.9%), and good (47.7%) groups. The MoCA trajectories were mainly stable. We conclude that cognitive impairment was frequent but, for most patients, was not affected by RT. For older patients with cancer, and in particular for those with physical impairments, we recommend an assessment of cognitive function.