Impact of Physical Inactivity on the Risk of Disability and Hospitalization in Older Patients with Advanced Lung Cancer

Abstract

This prospective observational study aimed to explore the influence of physical inactivity during initial chemotherapy on the risk of disability and hospitalization in later life among older patients with advanced non-small-cell lung cancer (NSCLC). Patients and Methods: Patients aged 70 or above who were scheduled to receive first-line chemotherapy for newly diagnosed advanced NSCLC were recruited for the study. An electronic pedometer was used to measure daily steps; based on the change rate (cutoff: −12.5%) from pretreatment to 12 ± 4 weeks after enrolment, patients were classified as active or inactive. The Barthel Index estimated activities of daily living. We compared disabilityfree survival time, mean cumulative functions of hospital stays, and medical costs, between the active and inactive groups. Results: Among the 29 patients enrolled, 21 were evaluable. Compared with active patients (n = 11), inactive patients (n = 10) showed shorter disability-free survival (6.4 vs 19.9 months, p < 0.05) and tended to have longer hospital stays (23.7 vs 6.3 days/person) and higher inpatient care cost (¥1.6 vs ¥0.3 million/person [US$16,000 vs US$3000/person]) during the first year. Conclusion: Physical inactivity during initial chemotherapy may be a risk factor for developing disability and requiring hospitalization in later life for older patients with advanced NSCLC. Our findings may indicate the need for lifestyle interventions with multidisciplinary teams, which include physicians, nurses, and physiotherapists, for older patients with advanced lung cancer during an active cancer treatment. A large-sample-sized study is needed to validate our findings.

The Use of Wearable Devices in Oncology Patients: A Systematic Review

“…Particularly in the context of patients with cancer who underwent surgery, early mobilization and physical activity has been shown to be important for decreasing hospital length of stay and, in turn, healthcare costs. 10 , 141 , 207 According to Hall et al, hospital inpatient and hospice stays, community care, outpatient appointments, out-of-hours service, and travel costs were the main costs related to cancer rehabilitation. 70 Evidently, the adoption of wearable devices can address most if not all of these cost drivers.…”

Sleep quality and sedentary behavior among cancer survivors: is there a possible link?

“…12 Huang et al 13 reported that the deleterious effect of poor sleep was exacerbated by physical inactivity in the context of all causes and disease-specific mortality with an above tenyear follow-up in a sample of nearly four hundred thousand people. Yonenaga et al 14 also reported that poor physical activity patterns were highly associated with diminished disability and survival among lung cancer patients. Tabaczynski et al 15 reported that even ten minutes of decreased physical inactivity daily leads to increased quality of life among kidney cancer survivors.…”