Physical function measurement in older long-term cancer survivors

Rubens

et al. 2023

Hisp Health Care Int

Introduction: This study reports characteristics of Hispanic women with breast cancer with respect to physical function, body mass index (BMI), and depression. Methods: This retrospective study included 322 Hispanic women with breast cancer. Physical function and fatigue were assessed using the Patient Reported Outcomes Measurement System-Physical Function (PROMIS-PF) short form and PROMIS-Fatigue (PROMISE-F) short form. In addition, Timed Up and Go (TUG) test, sit to stand in 30 s (STS30) test, four-stage balance test (4SB), and grip strength (GS) were measured. Depression was identified using Patient Health Questionnaire (PHQ)-2 and extracted from medical chart. Results: Nearly 40.8% were obese, and 20.8% had depression. Compared to normal BMI patients, mean PROMIS-F score was significantly higher among overweight and obese patients. The mean STS30 score was significantly lower in obese patients, compared to normal BMI patients. Regression analysis showed that the odds of depression were higher with increasing TUG and lower PROMIS-F, STS30, and GS. Conclusion: Hispanic women with breast cancer have substantial loss of physical function, and this is exaggerated if they are obese, overweight, or depressed. Clinicians caring for this population should screen them for the presence of loss of physical function, BMI, and depression.

Section: Discussionsupporting

confidence: 86%

Section: Discussioncontrasting

confidence: 80%

Characterization of Physical Function and Cancer-Related Physical Impairments in Hispanic Women With Breast Cancer: A Descriptive Study

Rubens

et al. 2023

Hisp Health Care Int

J American Geriatrics Society

“…Cancer survivors are at higher risk for physical function limitations compared to individuals without a history of cancer based on patient‐reported measures 6,13,14 . While patient‐reported physical function measures are important for understanding the lived experience of survivorship, objective physical function assessments are valid and reliable measures that can identify impairments amenable to rehabilitation interventions 15 . Prior studies that included objective measures of physical function focused on breast and prostate cancer survivors to the exclusion of other cancer types, with mixed findings regarding the presence of physical functional limitations 16–18 .…”

Section: Introductionmentioning

confidence: 99%

“…6,13,14 While patient-reported physical function measures are important for understanding the lived experience of survivorship, objective physical function assessments are valid and reliable measures that can identify impairments amenable to rehabilitation interventions. 15 Prior studies that included objective measures of physical function focused on breast and prostate cancer survivors to the exclusion of other cancer types, with mixed findings regarding the presence of physical functional limitations. [16][17][18] Although breast and prostate are the most common cancer types, less is known about physical function in older adults with other cancer types and how physical function impairments might differ between men and women with a cancer history.…”

Section: Introductionmentioning

confidence: 99%

Physical function in older adults with and without a cancer history: Findings from the National Health and Aging Trends Study

Gell

Bae

Patel

et al. 2023

BackgroundPrevious studies identified physical function limitations in older cancer survivors, but few have included objective measures and most focused on breast and prostate cancer survivors. The current study compared patient‐reported and objective physical function measures between older adults with and without a cancer history.MethodsOur cross‐sectional study used a nationally representative sample of community‐dwelling, Medicare beneficiaries from the 2015 National Health and Aging Trends Study (n = 7495). Data collected included patient‐reported physical function, including a composite physical capacity score and limitations in strength, mobility, and balance, and objectively measured physical performance metrics, including gait speed, five time sit‐to‐stand, tandem stand, and grip strength. All analyses were weighted to account for the complex sampling design.ResultsThirteen percent of participants (n = 829) reported a history of cancer, of which more than half (51%) reported a diagnosis other than breast or prostate cancer. In models adjusted for demographics and health history, older cancer survivors had lower Short Physical Performance Battery scores (unstandardized beta [B] = −0.36; 95% CI: −0.64, −0.08), slower gait speed (B = −0.03; 95% CI: −0.05, −0.01), reduced grip strength (B = −0.86; 95% CI: −1.44, −0.27), worse patient‐reported composite physical capacity (B = −0.43; 95% CI: −0.67, −0.18) and patient‐reported upper extremity strength (B = 1.27; 95% CI: 1.07, 1.50) compared to older adults without cancer. Additionally, the burden of physical function limitations was greater in women than in men, which may be explained by cancer type.ConclusionsOur results extend studies in breast and prostate cancer to show worse objective and patient‐reported physical function outcomes in older adults with a range of cancer types compared to those without a cancer history. Moreover, these burdens seem to disproportionately affect older adult women, underscoring the need for interventions to address functional limitations and prevent further health consequences of cancer and its treatment.

“…The CGA has historically been adopted to identify elderly patients who are unfit for intense oncologic treatment, but is time-consuming and therefore costly. Next to a geriatric assessment, specific physical function in older adults can be assessed by performance tests [ 13 ]. Timely identifying high-risk patients before the start of treatment is important to be able to initiate preventive interventions to improve treatment outcomes.…”

Section: Introductionmentioning

confidence: 99%

Association of Pretreatment Physical and Geriatric Parameters with Treatment Tolerance and Survival in Elderly Patients with Stage I–II Non-Small Cell Lung Cancer: An Evaluation of Usual Care Data

Voorn

Bootsma

et al. 2022

Cancers

In this study, the association of pretreatment physical and geriatric parameters with treatment tolerance and survival in elderly patients with stage I–II NSCLC was evaluated. Retrospective data for patients aged ≥ 70 years, diagnosed between 2016 and 2020 with stage I–II NSCLC, and who underwent surgery or stereotactic ablative radiotherapy (SABR) in a large Dutch teaching hospital were retrieved from medical records. Associations of pretreatment physical and geriatric parameters with treatment tolerance and survival were analyzed. Of 160 patients, 49 of 104 (47%) patients who underwent surgery and 21 of 56 (38%) patients who received SABR did not tolerate treatment. In univariable analysis, World Health Organization (WHO) performance status ≥ 2, short nutritional assessment questionnaire score >1, short physical performance battery score ≤ 9, and geriatric-8 score ≤ 14 were significantly associated with postoperative complications. Forced expiratory volume of one second < 80% of predicted was significantly associated with intolerance of SABR. In multivariable analysis, WHO performance status ≥ 2 and diffusing capacity for carbon monoxide < 80% were significantly associated with decreased overall survival. This is the first study that investigated the association between pretreatment physical and geriatric parameters and treatment outcomes in patients with stage I–II NSCLC. Evaluation of physical and geriatric parameters before treatment initiation seems highly recommended to select patients who might benefit from preventive interventions before and/or during treatment.