Fatigue and Physical Activity in Older Adults With Cancer

Abstract

Cancer is a disease predominantly affecting older adults. Cancer fatigue is the most common and often most distressing symptom associated with cancer and its treatment, often persisting months to years after treatment. Untreated cancer fatigue may lead to significant reductions in physical activity, physical functioning, and quality of life and may interfere with patients' adherence to cancer treatment. Physical activity has the strongest supporting evidence as an intervention to reduce cancer fatigue, maintain physical function, and optimize quality of life. This article reviews the literature related to fatigue and physical activity in older adults with cancer. Nine experimental and 10 observational studies that enrolled subjects 65 years or older were synthesized in the review and provided evidence that physical activity may be an effective intervention for cancer fatigue in older adults. The generalizability of the findings to older adults was limited by the poor representation of this age group in the studies. Few studies provided an analysis of age-related effects of physical activity on fatigue, physical function, and quality of life.

An update of controlled physical activity trials in cancer survivors: a systematic review and meta-analysis

“…These reviews have focused on specific outcomes, primarily fatigue and quality of life, and populations, including elderly survivors, patients during treatment, or certain cancer types [4][5][6][7][8][9][10][11][12]. Galvão et al [13] provided a qualitative review of exercise intervention studies during and post treatment for all cancers, and a quantitative metaanalyses on physical activity interventions in all adult cancers was published in 2006 [14].…”

Self-directed physical activity intervention in older adults undergoing adjuvant chemotherapy for colorectal cancer: Design of a randomized controlled trial

“…A further concern is that the average age of participants in three studies [48,50,51] is below our target population of 60 or older and the age range in the largest of the six studies [49] is only 65 to 68. A specific focus on older patients is a known gap in the physical activity-cancer related fatigue literature [12].…”

“…Fatigue in cancer patients is of clinical concern because it is associated with decreased physical activity, lower functional status, and impaired quality of life [11]. In older cancer patients, specifically, additional concerns are that long-lasting fatigue undermines function (physical performance, activities of daily living) which, in turn, can disrupt treatment regimens and increase the risk for institutional care [10,[12][13][14][15]. Among older adults in general, fatigue is a self-reported indicator of aging and frailty, signaling decreased physiologic reserves for coping with stressors and increased risk for mortality [14,15].…”

“…Among older adults in general, fatigue is a self-reported indicator of aging and frailty, signaling decreased physiologic reserves for coping with stressors and increased risk for mortality [14,15]. Although 60% of all cancers are diagnosed in adults age 65 or older, few studies to date have focused on understanding and managing fatigue in older cancer patients [10,12].…”

Research Priorities in Geriatric Palliative Care: Nonpain Symptoms

“…[20][21][22][23][24][25][26][27] a) Fatigue, dyspnea, and sleep disturbances Symptoms of fatigue, dyspnea, and sleep disturbances (including both insomnia and hypersomnolence) are significantly elevated among individuals with cancer, ESRD, HF, and PD compared to healthy older adults. [28][29][30][31] For example, fatigue is experienced by 60%-97% of ESRD patients; 32 dyspnea is reported by over three-fourths of older adults with advanced HF; 33 and 40%-90% of PD patients report sleep disturbances. These symptoms are consistently correlated with poor quality of life and may be more common in older adults than younger individuals with the same disease.…”