Activities, function, and health-related quality of life (HRQOL) of older adults with cancer

Abstract

Purpose This study aims to (1) describe the activities, function, and health-related quality of life (HRQOL) of a large sample of older adults (age ≥ 65) with cancer, (2) identify the associations with demographics, cancer type, comorbid conditions, and ability to participate in activities and functional status. Methods The Health Registry/Cancer Survivorship Cohort is an institutional database designed to aid cancer survivorship research. The registry includes three measures of patient-reported HRQOL: FACT-G and PROMIS® Global measures for physical and mental health. Other measures included in the registry are cancer type, date from diagnosis, number of comorbid conditions and specific conditions and their limitations in daily activity, and self-reported daily activity/function. Results Our sample consists of 768 older adults with cancer, mean age 72 years, 60% female, and 90% White. Mean scores for HRQOL: FACT-G (85, range: 25–108), PROMIS-physical (48, range: 16–67) and, PROMIS-mental (51, range: 21–67). In multivariable models, Black race, one or more comorbid conditions, and Gastrointestinal cancer (p < .05), and patient- reported decreased levels of activities/function were all independently associated with poor HRQOL (p < .0001). Conclusions Older Black adults with cancer, those that have high comorbidity burden, with gastrointestinal cancers and those that report decreased ability to participate in daily activities/function reported poorer HRQOL. As geriatric oncology moves towards trying to identify who may need supportive services, this study demonstrated that a one question patient-reported level of activities and functional ability were independently associated with physical, mental, and cancer-specific HRQOL.

Most impactful factors on the health‐related quality of life of a geriatric population with cancer

“…Moreover, because respondents were surveyed at different times along the cancer journey, the results herein indicate that symptom assessment followed by appropriate supportive interventions is important in the lives of older survivors. A significant association between increased comorbidities and poorer HRQOL has been demonstrated in several previous studies . Currently, to the best of our knowledge, only limited literature exists regarding the quality of care for comorbid conditions among cancer survivors, with such quality varying across cancer types and physician specialty .…”

“…A significant association between increased comorbidities and poorer HRQOL has been demonstrated in several previous studies. 4,29,30 Currently, to the best of our knowledge, only limited literature exists regarding the quality of care for comorbid conditions among cancer survivors, with such quality varying across cancer types and physician specialty. 31,32 In the current study, HRQOL also was found to be compromised in those who expressed support needs related to debilitated physical health (eg, the need to have someone to help when fatigued).…”

Equitably improving outcomes for cancer survivors and supporting caregivers: A blueprint for care delivery, research, education, and policy

“…Survivors with lower income, less education, or more comorbid conditions; those who are unemployed; and those who are uninsured or underinsured have higher ongoing symptom burden . Survivors who are from racial/ethnic minority groups or are socioeconomically disadvantaged and those with more comorbid conditions report worse quality of life …”

“…31 Survivors who are from racial/ethnic minority groups or are socioeconomically disadvantaged and those with more comorbid conditions report worse quality of life. 36,37 In addition to ongoing symptoms and functional impairment after the successful completion of anticancer treatment, survivors are at increased risk for several cancer-related issues. For many cancer survivors, the initial course of treatment is successful, and the cancer never recurs.…”

Follow the trail: Using insights from the growth of palliative care to propose a roadmap for cancer rehabilitation

“…The estimate is slightly higher in older adults, in which 64% of older adults with cancer report some form of functional limitation. 2 If unaddressed, these functional limitations can affect productivity, 3,4 quality of life, 5,6 and overall survival. 7 Rehabilitation services have the potential to reduce the functional limitations experienced by cancer survivors.…”