Distinct Physical Function Profiles in Older Adults Receiving Cancer Chemotherapy

Miaskowski, Christine; Wong, Melisa L.; Cooper, Bruce A.; Mastick, Judy; Paul, Steven M.; Possin, Katherine L.; Steinman, Michael A.; Cataldo, Janine; Dunn, Laura B.; Ritchie, Christine S.

doi:10.1016/j.jpainsymman.2017.07.018

Cited by 21 publications

(16 citation statements)

References 69 publications

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“…A recent study also identified three patient groups with distinct trajectories of patient-reported physical function, i.e. poor, intermediate, and good [38], though these were all stable. Supporting our finding, depression, and lower physical activity were among the main characteristics within the poor group.…”

Section: Discussionmentioning

confidence: 94%

“…Secondly, the choice of assessment tools may have impacted our results. This particularly applies to our comorbidity assessment, since comorbidity has been found to affect older patients' physical function and QoL in other studies using more comprehensive assessments than the OARS [38,54]. Thirdly, the multitude of factors included in our analyses may introduce uncertainties, and the exploratory analysis related to PF trajectories should be interpreted with caution.…”

Section: Discussionmentioning

confidence: 99%

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Modifiable factors affecting older patients' quality of life and physical function during cancer treatment

Kirkhus

Harneshaug

Benth

et al. 2019

Journal of Geriatric Oncology

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Background: Maintaining physical function and quality of life (QoL) are prioritized outcomes among older adults. We aimed to identify potentially modifiable factors affecting older patients' physical function and QoL during cancer treatment. Methods: Prospective, multicenter study of 307 patients with cancer ≥70 years, referred for systemic treatment. Pre-treatment, a modified geriatric assessment (mGA) was performed, including registration of comorbidities, medications, nutritional status, cognitive function, depressive symptoms (Geriatric Depression Scale-15 [GDS]), and mobility (Timed Up and Go [TUG]). Patient-reported physical function (PF)-, global QoL-, and symptom scores were assessed at baseline, two, four, and six months by the EORTC Quality of Life Core Questionnaire-C30. The impact of mGA components and symptoms on patients' PF and global QoL scores during six months was investigated by linear mixed models. To identify groups following distinct PF trajectories, a growth mixture model was estimated. Results: 288 patients were eligible, mean age was 76.9 years, 68% received palliative treatment. Higher GDSscores and poorer TUG were independently associated with an overall level of poorer PF and global QoL throughout follow-up, as were more pain, dyspnea, and appetite loss, and sleep disturbance. Three groups with distinct PF trajectories were identified: a poor group exhibiting a non-linear statistically (p b .001) and clinically significant decline (≥10 points), an intermediate group with a statistically (p = .003), but not clinically significant linear decline, and a good group with a stable trajectory. Higher GDS-scores and poorer TUG, more pre-treatment pain and dyspnea were associated with higher odds of belonging to the poor compared to the good PF group. Conclusion: Depressive symptoms, reduced mobility, and more physical symptoms increased the risk of decrements in older patients' PF and global QoL scores during cancer treatment, and represent potential targets for interventions aiming at improving these outcomes.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Modifiable factors affecting older patients' quality of life and physical function during cancer treatment

Kirkhus

Harneshaug

Benth

et al. 2019

Journal of Geriatric Oncology

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“…malnutrition, etc. ), cancer and its treatment confer a range of effects which reduce quality of life (QoL) [10]. One recent study found that nearly two-thirds of older people assessed in hospital had at least one tissue loss syndrome (i.e.…”

Section: Introductionmentioning

confidence: 99%

Physical activity and nutrition interventions for older adults with cancer: a systematic review

et al. 2020

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The aim of this review was to summarize the current literature for the effectiveness of activity and nutritional based interventions on health-related quality of life (HRQoL) in older adults living with and beyond cancer (LWBC). Methods We conducted systematic structured searches of CINAHL, Embase, Medline, Cochrane CENTRAL databases, and bibliographic review. Two independent researchers selected against inclusion criteria: (1) lifestyle nutrition and/or activity intervention for people with any cancer diagnosis, (2) measured HRQoL, (3) all participants over 60 years of age and (4) randomized controlled trials. Results Searches identified 5179 titles; 114 articles had full text review, with 14 studies (participant n = 1660) included. Three had nutrition and activity components, one, nutrition only and ten, activity only. Duration ranged from 7 days to 1 year. Interventions varied from intensive daily prehabilitation to home-based gardening interventions. Studies investigated various HRQoL outcomes including fatigue, general and cancer-specific quality of life (QoL), distress, depression, global side-effect burden and physical functioning. Eight studies reported significant intervention improvements in one or more QoL measure. Seven studies reported using a psychosocial/theoretical framework. There is a gap in tailored nutrition advice. Conclusions Among the few studies that targeted older adults with cancer, most were activity-based programmes with half reporting improvements in QoL. Future research should focus on or include tailored nutrition components and consider appropriate behaviour change techniques to maximize potential QoL improvement. Implications for Cancer Survivors More research is needed to address the research gap regarding older adults as current recommendations are derived from younger populations.

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“…Chemotherapy is helpful for improving survival, while it may also cause adverse consequences in quality of life (QOL; Brahmer et al., ; Quinten et al., ; Udupa, Rajendranath, & Sagar, ; Zietarska, Krawczyk‐Lipiec, Kraj, Zaucha, & Malgorzewicz, ), fatigue (Levkovich, Cohen, & Karkabi, ; Sette et al., ; Vardy et al., ), depression (Bergerot, Mitchell, Ashing, & Kim, ; Bhattacharyya, Bhattacherjee, Mandal, & Das, ; Zhang, Zhou, Feng, Xu, & Zeng, ), anxiety (Charalambous, Kaite, Charalambous, Tistsi, & Kouta, ; Papadopoulou et al., ), body composition (Palmela et al., ; Rier et al., ), and physical functioning (Miaskowski et al., ; Timilshina, Breunis, Tomlinson, Brandwein, & Alibhai, ). Many non‐pharmacological interventions are proposed to prevent or reduce these adverse consequences (Can, Erol, Aydiner, & Topuz, ) and accumulating evidence implies that exercise may effectively reduce side effects caused by chemotherapy (Meneses‐Echavez, Gonzalez‐Jimenez, & Ramirez‐Velez, ).…”

Section: Introductionmentioning

confidence: 99%

Effects of Exercise During or Postchemotherapy in Cancer Patients: A Systematic Review and Meta‐Analysis

Zeng

Tang

et al. 2019

Worldviews Ev Based Nurs

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Background: Exercise may effectively reduce side effects caused by chemotherapy. However, no meta-analyses of exercise during or postchemotherapy for cancer patients have been definitely performed to guide clinical practice.Aims: To evaluate and summarize available scientific evidence to provide recommendations of an exercise intervention for cancer patients undergo chemotherapy.Methods: A systematic review and meta-analysis were performed with databases searching of MEDLINE, Cochrane Library, and Embase from their inception to October 15, 2017. Literature was selected to identify randomized controlled trials of exercise during or postchemotherapy for cancer patients. Risk-of-bias assessment was performed by two reviewers independently. Data were analyzed using the Cochrane Collaboration's RevMan 5.3 (Review Man, Copenhagen, Denmark).Results: A total of 10 trials with 838 participants were included in our study. Exercise could have a beneficial effect in cancer patients undergo chemotherapy in the outcome of physical fitness (MD: 0.16, 95% CI: 0.08-0.25, p < .01 and MD: 2.46, 95% CI: 1.44-3.47, p < .01) and depression (MD: −1.36, 95% CI: −2.68 to −0.04, p = .04), but not in FACT-G, FACT-B, anxiety, weight, and BMI (all p > .05). Exercise sequence (during or postchemotherapy) did not influence the effect of exercise for cancer patients undergo chemotherapy. In total, six studies were assessed as an overall low risk of bias. Subgroup analyses and sensitivity analyses reached results similar to those of the meta-analyses, which reflected our results were reliable and robust.Linking Evidence to Action: Exercise seems to have a beneficial effect on physical fitness and depression, but not on quality of life, anxiety, weight, and BMI. More specific and detailed description of the implementation of exercise programs should be proposed in the future.

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Distinct Physical Function Profiles in Older Adults Receiving Cancer Chemotherapy

Cited by 21 publications

References 69 publications

Modifiable factors affecting older patients' quality of life and physical function during cancer treatment

Modifiable factors affecting older patients' quality of life and physical function during cancer treatment

Physical activity and nutrition interventions for older adults with cancer: a systematic review

Effects of Exercise During or Postchemotherapy in Cancer Patients: A Systematic Review and Meta‐Analysis

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