Activity of daily living problems in older cancer survivors: a population-based controlled study

Abstract

The ability to perform activities of daily living (ADL) is a crucial factor for independent functioning and living at home. This population-based cross-sectional study examines ADL problems in older cancer survivors compared with an age-matched cancer-free control group. According to both The Cancer Registry of Norway and self-report, 911 individuals > or =70 years had invasive cancer among the participants of The Health Study of Nord-Trøndelag County (HUNT-2) 1995-7. Three age- and gender-matched cancer-free controls for each cancer survivor were drawn from HUNT-2 (N = 2733). Personal- and Instrumental-ADL (P-ADL and I-ADL) problems were self-rated. P-ADL problems addressed activities such as personal hygiene, dressing and eating, while I-ADL problems concerned household activities, managing finances, shopping and administration of medication. Associations among relevant independent variables and P- and I-ADL problems were examined with both descriptive and multivariate statistics. P-ADL problems were present in 10% of the cancer survivors and 8% of the controls (P = 0.02). Correspondingly, 38% of the cancer survivors had I-ADL problems versus 32% of the controls (P < 0.001). Older cancer survivors with co-morbidity showed significantly higher rates of P-ADL and I-ADL problems compared with controls with co-morbidity (14% versus 9%, P = 0.01, and 47% versus 39%, P = 0.02). Cancer survivors with co-morbidity had significantly more P-ADL and I-ADL problems than survivors without co-morbidity (14% versus 8%, P = 0.01 and 47% versus 32%, P < 0.001). This study showed higher incidence of ADL problems among a population of older cancer survivors compared with cancer-free controls. Somatic co-morbidity further increased the prevalence of both P- and I-ADL problems in the cancer survivors. Primary healthcare providers should pay attention to and assess ADL problems in older cancer survivors.

Insomnia in elderly cancer survivors—a population-based controlled study of associations with lifestyle, morbidity, and psychosocial factors. Results from the Health Survey of North-Trøndelag County (HUNT-2)

“…Activity of daily living (ADL) problems were defined as tasks to be maintained every day and divided into personal (P-ADL) problems and instrumental (I-ADL) problems corresponding to suggested categorisation [25]. Cronbach's coefficient alpha was 0.85 and 0.82 for P-ADL and I-ADL problems, respectively.…”

Pain, fatigue, anxiety and depression in older home‐dwelling people with cancer

“…The symptom combination of pain, fatigue, anxiety and depression puts a high burden on the people with cancer. The consequences can be reduced ability to cope with activities of daily living (Grov, Fossa, & Dahl, , ), which may lead to the need for help and support while living at home. People with cancer often face remarkable pain problems with varying origins, such as the disease itself and its treatment (Chang, Arnold, & Savarese, ; Dawn, ).…”

Predictors of Quality of Life for Long-Term Cancer Survivors With Preexisting Disabling Conditions

“…While all cancer survivors may experience long-term effects following the acute survivorship phase (National Cancer Institute [NCI], 2004), those with functional limitations resulting from pre-existing impairments may have special concerns related to their diagnosis and treatment. Previous research has shown that co-morbid health problems or disabling conditions can directly impact treatment, prognosis, and longer term outcomes for cancer survivors, including the ability to maintain health and carry out activities of daily living (Beck, Towsley, Caserta, Lindau, & Dudley, 2009; Gonzalez, Ferrante, Van Durme, Pal, & Roetzheim, 2001; Grov, Fossa, & Dahl, 2010; NCI, 2004; Piccirillo et al, 2003; Piccirillo, Tierney, Costas, Grove, & Spitznagel, 2004). Those with prior limitations in activities of daily living struggle to promote their health and prevent secondary disabling conditions under the best of circumstances (U.S.…”