Functional decline among older cancer survivors in the Baltimore longitudinal study of aging. Issue 11 (3rd August 2021)

• Record Type: Journal Article
• Authors: Siddique, Arfan; Simonsick, Eleanor M.; Gallicchio, Lisa
• Is Part Of: Journal of the American Geriatrics Society. Volume 69:Issue 11(2021)
• Page Start: 3124
• Page End: 3133
• Publication Date: 2021-08-03
• Subjects: aging -- cancer -- functional decline -- gait speed -- grip strength; Geriatrics -- Periodicals; 618.97
• DOI: 10.1111/jgs.17369
• Languages: English
• ISSNs: 0002-8614

Abstract

Abstract: Background: Evidence has begun to emerge indicating that cancer survivors experience accelerated aging. This study examines this phenomenon by evaluating trajectories of functional decline in older adults with a history of a cancer diagnosis relative to those without a history of cancer. Methods: Community dwelling healthy volunteers in the Baltimore Longitudinal Study of Aging were evaluated in the Clinical Research Unit of the National Institute on Aging Intramural Research Program. Between 2006 and 2019, 1728 men and women (aged 22–100) underwent clinical evaluation of functional status; 359 reported having a history of cancer. Longitudinal associations between self‐reported cancer history and measures of functional decline were examined using generalized estimating equations. Additionally, time‐to‐event and Cox proportional hazards models were used to examine trajectories of decline. Where appropriate, age‐stratified associations were examined, and models were adjusted for sex, body mass index, race, smoking status, education, and number of comorbid conditions. Results: Among all participants, a history of cancer was associated with 1.42 (95% CI 1.11–1.81) greater odds of weak grip strength. Among older participants (>65 years of age), those with a history of cancer had 1.61 (95% CI 1.28, 2.02) greater odds of slow gait speed and a 0.11 unit (95% CI 0.19–0.03) lower physical performance score than those with no cancer history. Time‐to‐event analysis showed that older individuals with a history of cancer experienced steeper decline in grip strength and gait speed than older adults with no history of cancer ( p < 0.01). Conclusion: Cancer survivors, especially older individuals, demonstrate greater odds of and accelerated functional decline, suggesting that cancer and/or its treatment may alter aging trajectories. Observational and intervention studies are needed for prevention, mitigation, and/or reversal of aging‐related effects of cancer and its treatment. Abstract : See related editorial by Sedrak et al .