Format

Send to

Choose Destination
J Geriatr Oncol. 2019 Jan;10(1):60-67. doi: 10.1016/j.jgo.2018.05.017. Epub 2018 Jun 22.

Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults.

Author information

1
The Ohio State University, Medical Oncology (For correspondence and reprints), B424 Starling Loving Hall 320 W, 10th Avenue, Columbus, OH 43214, USA. Electronic address: carolyn.presley@osumc.edu.
2
Yale School of Medicine, Department of Internal Medicine, New Haven, CT, USA.
3
City of Hope Comprehensive Cancer Center, Medical Oncology Duarte, CA, USA.

Abstract

BACKGROUND:

To characterize functional trajectories in the year before and after a new cancer diagnosis among older adults and to identify risk factors for worsening disability post-diagnosis.

METHODS:

We identified 170 participants 70+ years with monthly assessments of thirteen basic, instrumental, and mobility activities and with a new cancer diagnosis from 1998 to 2014. A group-based trajectory model identified distinct functional trajectories based on a total disability score during the twelve months pre- and post-diagnosis. We evaluated associations between potential risk factors at the time of cancer diagnosis and worsening disability post-diagnosis, explored functional transitions from pre- to post-diagnosis and identified participants whose functional trajectories worsened.

RESULTS:

Three pre-diagnosis functional trajectories were identified among 170 participants (mean age at diagnosis: 83 years (range: 73-105 years): mild, moderate, and severe disability. Three post-diagnosis functional trajectories were identified among 158 non-decedents: mild, moderate, and severe disability. Most participants (93.9%) with severe disability pre-diagnosis had severe disability post-diagnosis. Risk factors independently associated with worsening disability post-diagnosis included moderate or severe disability pre-diagnosis (adjusted risk ratio, aRR: moderate: 2.96; 95%CI: 2.11-4.16; severe: 5.11; 95%CI: 3.07-8.52) vs. mild (reference), poor physical capability (aRR: 1.57; 95%CI: 1.07-2.30), and incurable stage (aRR:1.99; 95%CI: 1.41-2.80). 40% of participants with a mild or moderate disability trajectory pre-diagnosis transitioned to a worse functional trajectory post-diagnosis.

CONCLUSION:

Older adults followed distinct functional trajectories in the twelve months before and after cancer diagnosis. Functional trajectory pre-diagnosis, poor physical capability, and incurable stage were independent risk factors for worsening disability post-diagnosis.

KEYWORDS:

Activities of daily living; Disability; Driving; Functional status; Independent activities of daily living; Mobility; Risk factors

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center