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J Geriatr Oncol. 2017 Mar;8(2):133-139. doi: 10.1016/j.jgo.2016.12.002. Epub 2016 Dec 13.

Motivation and mortality in older women with early stage breast cancer: A longitudinal study with ten years of follow-up.

Author information

1
Internal Medicine Residency Program, Boston Medical Center, 72 East Concord Street, Evans 124, Boston, MA 02118, USA.
2
Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH 3012 Bern, Switzerland.
3
Section of Geriatrics, Boston Medical Center/Boston University School of Medicine, 88 East Newton Street, Robinson Building, Boston, MA 02118, USA. Electronic address: rsillima@bu.edu.
4
Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
5
Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH 3012 Bern, Switzerland; Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Switzerland.

Abstract

OBJECTIVES:

The Getting Out of Bed Scale (GOB) was validated as a health-related quality of life (HRQoL) variable in older women with early stage breast cancer, suggesting its potential as a concise yet powerful measure of motivation. The aim of our project was to assess the association between GOB and mortality over 10years of follow-up.

MATERIALS AND METHODS:

We studied 660 women ≥65-years old diagnosed with stage I-IIIA primary breast cancer. Data were collected over 10years of follow-up from interviews, medical records, and death indexes.

RESULTS:

Compared to women with lower GOB scores, women with higher GOB had an unadjusted hazard ratio (HR) of all-cause mortality of 0.78 at 5years, 95% confidence interval (CI) (0.52, 1.19) and 0.77 at 10years, 95%CI (0.59, 1.00). These associations diminished after adjusting for age and stage of breast cancer, and further after adjusting for other HRQoL variables including physical function, mental health, emotional health, psychosocial function, and social support. Unadjusted HRs of breast cancer-specific mortality were 0.92, 95%CI (0.49, 1.74), at 5years, and 0.82, 95%CI (0.52, 1.32), at 10years. These associations also decreased in adjusted models.

CONCLUSION:

Women with higher GOB scores had a lower hazard of all-cause mortality in unadjusted analysis. This effect diminished after adjusting for confounding clinical and HRQoL variables. GOB is a measure of motivation that may not be independently associated with cancer mortality, but reflects other HRQoL variables making it a potential outcome to monitor in older patients with cancer.

KEYWORDS:

Breast cancer; Disease-specific mortality; Geriatric oncology; Health-related quality of life; Mortality; Motivation; Quality of life; Risk stratification; Survivorship

PMID:
27986501
PMCID:
PMC5373974
DOI:
10.1016/j.jgo.2016.12.002
[Indexed for MEDLINE]
Free PMC Article

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