Background: Given the increase in incidence and mortality from cancer in recent years in Latin America and Peru, it is necessary to identify frailty older adults at higher risk of disability, hospitalizations and mortality. However, its measure is complex and requires time. For this reason, it has been proposed that frailty can be evaluated by a single measure, as gait speed. We aimed to evaluate the role of gait speed as a predictor of mortality in older men with cancer in Peru. Methods: A prospective cohort study was carried out that included military veterans (aged 60 years and older) with an oncological diagnosis evaluated at the Centro M edico Naval in Peru during the period 2013-2015. Slow gait speed was defined as <0.8 m/s. All-cause mortality was recorded during a 2-year follow-up. Sociodemographic characteristics, medical and personal history, and functional assessment measures were collected. We performed Cox regression analysis to calculate hazard ratios with their respective 95% confidence intervals. Results: 922 older men were analyzed from 2013 to 2015, 56.9% (n ¼ 525) of whom were >70 years of age. 41.3% (n ¼ 381) had slow gait speed with a mortality incidence of 22.9% (n ¼ 211) at the end of follow-up. The most frequent types of cancer in the participants who died were of the lung and airways (26.1%), liver and bile ducts (23.2%), and lymphomas and leukemias (16.6%). In the adjusted Cox regression analysis, we found that slow gait speed was a risk factor for mortality in older men with cancer (adjusted hazard ratio ¼ 1.55; 95% confidence interval: 1.21-2.23). Conclusions: Slow gait speed was associated with an increased risk of mortality in older men with cancer. Gait speed could represent a simple, useful, inexpensive, rapidly applicable marker of frailty for the identification of older men at higher risk of mortality. Gait speed could be useful in low-and middle-income countries, and in rural areas with limited access to health services.
Objetivo: Evaluar a la velocidad de marcha lenta como factor de riesgo para mortalidad en adultos mayores con cáncer de Perú. Métodos: Se realizó un estudio de tipo cohorte retrospectiva mediante un análisis secundario de datos que incluyó adultos mayores militares retirados con diagnóstico oncológico evaluados en el Centro Médico Naval del Perú durante el periodo 2013-2015. Se definió la velocidad de marcha lenta como un valor menor a 0,8 m/s. Se consideró la mortalidad por todas las causas registrada durante el tiempo de seguimiento. Se incluyeron características sociodemográficas, antecedentes médicos y personales y medidas de evaluación funcional. Se realizó un análisis de regresión de Cox crudo y ajustado por potenciales confusores. Se estimaron Hazard Ratios (HR) con sus respectivos intervalos de confianza al 95% (IC95%). Resultados: Se analizó a 922 adultos mayores varones y el 56,94% (n=525) eran mayores de 70 años. El 41,32% (n=381) de los participantes presentó velocidad de marcha lenta y la mortalidad al final del seguimiento fue del 22,89% (n=211). Los tipos de cáncer más frecuentes en los participantes que fallecieron fueron los de pulmón y vías aéreas (26,07%), hígado y vías biliares (23,22%) y linfomas y leucemias (16,59%). En el análisis de regresión de Cox ajustado, se halló que la velocidad de marcha lenta fue un factor de riesgo para mortalidad en adultos mayores con cáncer (HR=1,55; IC95%: 1,21-2,23). Conclusiones: La velocidad de marcha lenta se asoció a un mayor riesgo de mortalidad en adultos mayores con cáncer. La velocidad de marcha podría representar un marcador de fragilidad simple, útil, de bajo costo y de rápida aplicación para la identificación de adultos mayores en mayor riesgo a efectos adversos al tratamiento oncológico y mortalidad.
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