Effects of cancer history on functional age and mortality

Abstract

Background Cancer, its treatment, and associated adverse effects may accelerate the functional aging of cancer survivors. In the current study, the authors used geriatric assessment (GA) to compare the functional age of long‐term cancer survivors with that of similarly aged women without a cancer history, and to examine whether functional age influences all‐cause mortality differently between these 2 groups. Methods Participants included 1723 cancer survivors and 11,145 age‐matched, cancer‐free women enrolled in the Iowa Women's Health Study in 1986 who completed the 2004 questionnaire (at ages 73‐88 years). GA domain deficits included ≥2 physical function limitations, ≥2 comorbidities, poor general health, poor mental health, and underweight. The risk of all‐cause mortality was estimated for deficits in each GA domain between 4 groups based on the cross‐classification of the presence and/or absence of cancer history and GA domain deficit (the referent group was cancer‐free women without a GA deficit). Results Both cancer history and GA domain deficits significantly predicted 10‐year mortality for all GA domains. Cancer survivors without deficits had a 1.3‐fold to 1.4‐fold risk of mortality, similar to the 1.1‐fold to 1.7‐fold risk noted among cancer‐free women with deficits (all P < .05). Cancer survivors with deficits were found to have the highest mortality risk for 4 of 5 domains (hazard ratio range, 1.6‐2.0). Mortality risk increased with the increasing number of GA deficits, which was greater in cancer survivors compared with cancer‐free women. Conclusions Even without GA deficits, cancer survivors appear to have an excess risk of death compared with women without cancer, and these deficits add to mortality risk. Interventions are needed to maintain or improve functional/physiological capacity as women age, especially in cancer survivors.

Physical function measurement in older long-term cancer survivors

“…In the United States, nearly two-thirds (64%) of cancer survivors are estimated to be 65 years of age or older[ 7 ]. With the increasing number of older cancer survivors, declines in physical function in this population are a large concern[ 4 , 8 ].…”

“…Older cancer survivors often face physical conditions that impact function. Cancer and its treatment negatively affect multiple body systems, contributing to impaired functional mobility in cancer survivors [1][2][3][4][5] . With aging, the presence of comorbidity further exacerbates functional declines, putting older cancer survivors at an increased risk for impaired physical function in the years following cancer treatment 3,5,6 .…”

Features That Middle-aged and Older Cancer Survivors Want in Web-Based Healthy Lifestyle Interventions: Qualitative Descriptive Study

“…The risk of cancer increases with age; thus, cancer survivors aged ≥65 years are anticipated to comprise approximately 73% and aged 50 to 64 years approximately 18% of the survivors by 2040 [ 2 ]. Cancer survivors are at a greater risk of cancer recurrence or second malignancy [ 3 ], and accelerated aging [ 4 ], which increases mortality risk [ 5 ]. Healthy eating, physical activity, and weight management can attenuate these health risks and functional decline [ 6 , 7 ]; however, only 29% of cancer survivors have normal weight, 27% eat at least 5 daily servings of vegetables and fruit, and 47% engage in at least 150 minutes per week of aerobic physical activity (only 34% for older cancer survivors) [ 8 , 9 ].…”

Harvest for Health, a Randomized Controlled Trial Testing a Home-Based, Vegetable Gardening Intervention Among Older Cancer Survivors Across Alabama: An Analysis of Accrual and Modifications Made in Intervention Delivery and Assessment During COVID-19

“…The Harvest for Health home-based vegetable gardening intervention represents a novel and multifaceted approach aimed at improving a triad of important outcomes (ie, PF, V&F consumption, and PA) among a growing patient population that is at risk for comorbidity, second cancers, and functional decline. [2][3][4][5][6][7][8][9][10][11][12][13][14] Although there have been feasibility studies of vegetable gardening interventions conducted in community 35 and home-based settings, [47][48][49] all of which show promise in affecting lifestyle behaviors and other health outcomes among cancer survivors, all of these studies have relied on small samples and are underpowered. The Harvest for Health RCT described in this article will be the first fully 90 recruitment for Harvest for Health has been costly and labor-intensive.…”

“…1 Compared with individuals without a cancer history, cancer survivors are at increased risk for second malignancies, cardiovascular disease, osteoporosis, and functional impairment. [2][3][4][5][6][7][8][9][10][11][12][13][14] Because 44% of cancer survivors are living at least 10 years beyond diagnosis, 1 interventions are needed to prevent or delay age-and treatment-related morbidity.…”