Physical Function and Physical Activity in Older Breast Cancer Survivors: 5-Year Follow-Up from the Climb Every Mountain Study

Abstract

Background A decline in physical activity and the ability to perform activities of daily living (ADL) and instrumental activities of daily living (IADL) could interfere with independent living and quality of life in older patients, but may be prevented with tailored interventions. The aim of the current study was to assess changes in physical activity and ADL/IADL in the first 5 years after breast cancer diagnosis in a real-world cohort of older patients and to identify factors associated with physical decline. Methods Patients aged ≥70 years with in situ or stages I-III breast cancer were included in the prospective Climb Every Mountain cohort study. Linear mixed models were used to assess physical activity (according to Metabolic Equivalent of Task (MET) hours per week) and ADL/IADL (according to the Groningen Activity Restriction Scale (GARS)) over time. Secondly, the association with geriatric characteristics, treatment, quality of life, depression, apathy, and loneliness was analyzed. Results A total of 239 patients were included. Physical activity and ADL/IADL changed in the first 5 years after diagnosis (mean change from baseline −11.6 and +4.2, respectively). Geriatric characteristics at baseline were strongly associated with longitudinal change in physical activity and ADL/IADL, whereas breast cancer treatment was not. A better quality of life was associated with better physical activity and preservation of ADL/IADL, while depression and loneliness were negatively associated with these outcomes. Discussion Geriatric characteristics, loneliness, and depressive symptoms were associated with physical decline in older patients with breast cancer, while breast cancer treatment was not.

Prevalence of loneliness and associations with health behaviours and body mass index in 5835 people living with and beyond cancer: a cross-sectional study

“…Although the effect size observed was small, the results of this study converge with previous research reporting a decreased likelihood of engaging in physical activity in people who report higher levels of loneliness [ 18 ] and extend sparse findings of an association between loneliness and physical activity in people LWBC [ 34 , 35 ]. Lemij and colleagues' study in older women (aged 70+) diagnosed with breast cancer reported that increasing loneliness was associated with lower levels of physical activity over time [ 46 ].…”

“…Data exploring associations between loneliness and physical activity in people LWBC are lacking. In older breast cancer survivors, one prospective study found an inverse association between loneliness and physical activity over a five-year follow-up period [ 34 ], while another cross-sectional study found that lower social support and living alone was associated with lower levels of physical activity [ 35 ].…”

Apathy and Physical Activity: A Systematic Review and Meta-Analysis

“…Five of these questionnaire-based studies used the short form of the International Physical Activity Questionnaire (IPAQ-SF) 46,48,62,73,76 , which consists of 6 items assessing time spent in light (i.e., walking), moderate (e.g., carrying light loads, cycling at moderate speed, doubles tennis), and vigorous physical activity (e.g., digging, fast cycling, heavy lifting, aerobics) over the last 7 days 89 . The other questionnaires used to assess physical activity were: the long form version of the IPAQ (IPAQ-LF) (k = 4) 69,70,79,80 , the modified Baecke Habitual Physical Activity Questionnaire (BHPAQ) (k = 2) 34,84 , the Minnesota Leisure Time Physical Activity Questionnaire (k = 1) 70 , the Longitudinal Aging Study Amsterdam Physical Activity Questionnaire (LAPAQ) (k = 1) 83 , the National Health Interview Survey and the Minnesota Heart Survey Physical Activity Questionnaire (NHIS/MHS PAQ) (k = 1) 81 , the Nurses’ Health Study II Activity and Inactivity Questionnaire (NHST II Activity) (k = 1) 78 , Physical Activity Disability Scale (PADS) (k = 1) 33 , the Nord-Trøndelag Health Study-derived questions (HUNT) (k = 2) 72,77 , the Canadian Community Health Survey-derived questionnaire (CCHS) (k = 1) 68 , and the Physical Activity Scale for the Elderly (PASE) (k = 1) 36 .…”

Prospective, Multi-Institutional Observational Study of Deterioration in Activities of Daily Living in Elderly Patients After Lung Cancer Surgery

“…In a study with longer (5-year) follow-up, ADL change was investigated in 239 elderly patients with breast cancer, and Lemij et al. 40 reported that treatment was not associated with physical activities. Although it seemed that our results are not inconsistent with these previous reports, direct comparisons are difficult owing to differences in disease status and evaluation methods.…”