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Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults.

ABSTRACT: BACKGROUND:To characterize functional trajectories in the year before and after a new cancer diagnosis among older adults and to identify risk factors for worsening disability post-diagnosis. METHODS:We identified 170 participants 70+ years with monthly assessments of thirteen basic, instrumental, and mobility activities and with a new cancer diagnosis from 1998 to 2014. A group-based trajectory model identified distinct functional trajectories based on a total disability score during the twelve months pre- and post-diagnosis. We evaluated associations between potential risk factors at the time of cancer diagnosis and worsening disability post-diagnosis, explored functional transitions from pre- to post-diagnosis and identified participants whose functional trajectories worsened. RESULTS:Three pre-diagnosis functional trajectories were identified among 170 participants (mean age at diagnosis: 83?years (range: 73-105?years): mild, moderate, and severe disability. Three post-diagnosis functional trajectories were identified among 158 non-decedents: mild, moderate, and severe disability. Most participants (93.9%) with severe disability pre-diagnosis had severe disability post-diagnosis. Risk factors independently associated with worsening disability post-diagnosis included moderate or severe disability pre-diagnosis (adjusted risk ratio, aRR: moderate: 2.96; 95%CI: 2.11-4.16; severe: 5.11; 95%CI: 3.07-8.52) vs. mild (reference), poor physical capability (aRR: 1.57; 95%CI: 1.07-2.30), and incurable stage (aRR:1.99; 95%CI: 1.41-2.80). 40% of participants with a mild or moderate disability trajectory pre-diagnosis transitioned to a worse functional trajectory post-diagnosis. CONCLUSION:Older adults followed distinct functional trajectories in the twelve months before and after cancer diagnosis. Functional trajectory pre-diagnosis, poor physical capability, and incurable stage were independent risk factors for worsening disability post-diagnosis.

SUBMITTER: Presley CJ

PROVIDER: S-EPMC6526705 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults.

Presley C J CJ Han Ling L Leo-Summers Linda L Hurria Arti A Gross Cary P CP Davidoff Amy J AJ Allore Heather G HG Gill Thomas M TM

Journal of geriatric oncology 20180622 1

<h4>Background</h4>To characterize functional trajectories in the year before and after a new cancer diagnosis among older adults and to identify risk factors for worsening disability post-diagnosis.<h4>Methods</h4>We identified 170 participants 70+ years with monthly assessments of thirteen basic, instrumental, and mobility activities and with a new cancer diagnosis from 1998 to 2014. A group-based trajectory model identified distinct functional trajectories based on a total disability score du ...[more]

PMID: 29937422

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Project description:ObjectiveTo assess the association between SARS-CoV-2 infection and decreased hand grip strength (HGS).DesignLongitudinal population-based study.SettingCommunity-dwelling older adults (aged ≥60 years) living in a rural Ecuadorian village struck by the SARS-CoV-2 pandemic.ParticipantsOf 282 enrolled individuals, 254 (90%) finished the study.MeasurementsHGS was measured 3 months before (January 2020) and 9 months after the introduction of the virus into the population (January 2021). SARS-CoV-2 antibody testing was performed in two rounds: in May-June (early) and September-November (late), 2020. An independent association between SARS-CoV-2 infection and HGS decline was assessed by fitting linear mixed models for longitudinal data. Changes in HGS scores in SARS-CoV-2 seropositive subjects, according to the time elapsed since seroconversion, were compared with those who remained seronegative.ResultsOverall, 149 (59%) individuals became seropositive for SARS-CoV-2. The mean HGS (in kg) was 25.3 ± 8.3 at baseline and 23.7 ± 8.1 at follow-up (p = 0.028), with 140 individuals having >5% HGS decline between both measurements. The follow-up HGS measurement decreased by 1.72 kg in seropositive individuals, and by 0.57 kg in their seronegative counterparts (p < 0.001). SARS-CoV-2 seropositive individuals were 2.27 times more likely (95% CI: 1.33-3.87) to have a lower HGS measurement at the time of follow-up than those who remained seronegative. When compared with seronegative subjects, seropositive patients with early seroconversion were 3.41 times (95% CI: 1.73-6.74) more likely to have >5% HGS decline at the time of the follow-up than those with later, i.e., more recent, infections.ConclusionsThis study shows an independent deleterious impact of SARS-CoV-2 on HGS that is more marked among individuals with infections that occurred more than 8 months before follow-up HGS. Results suggest the possibility of chronic damage to skeletal muscles by SARS-CoV-2.

Dataset Information

Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults.

Publications

Functional trajectories before and after a new cancer diagnosis among community-dwelling older adults.

Similar Datasets

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