Klepin Heidi D, Mohile Supriya G, Mihalko Shannon
Wake Forest School of Medicine, Winston-Salem, NC 27157, USA.
Interdiscip Top Gerontol. 2013;38:146-57. doi: 10.1159/000343597. Epub 2013 Jan 17.
Older adults are at high risk for functional decline after a cancer diagnosis. Physiologic changes of aging which negatively impact body composition, strength, and fitness increase vulnerability to the development of short- and long-term disability when stressed with cancer burden and treatments. Treatment-associated physical disability impairs quality of life, limits therapeutic options, and contributes to the social and economic burden of cancer care in the elderly. Despite this, few clinical trials capture disability as an outcome or focus on whether it can be ameliorated in this population. Exercise has multiple positive effects on physical health and well-being in non-cancer elderly populations and holds promise as a supportive care intervention to improve physical function and symptoms during and after cancer treatments. The majority of studies supporting the positive benefits of exercise among cancer survivors have been performed in younger patients. Results from limited elderly-specific trials suggest that physical activity interventions are safe and effective in older cancer survivors, with prostate cancer survivors representing the best studied cohort of older persons with cancer. Many questions remain unanswered with respect to optimal timing, mode, intensity, and delivery of exercise interventions for older patients. While available data support the potential benefit of exercise for elders with cancer, recommendations will need to be individualized to optimize participation, safety, and efficacy.
癌症诊断后，老年人出现功能衰退的风险很高。衰老的生理变化会对身体成分、力量和体能产生负面影响，在承受癌症负担和接受治疗时，会增加出现短期和长期残疾的易感性。与治疗相关的身体残疾会损害生活质量，限制治疗选择，并加重老年癌症护理的社会和经济负担。尽管如此，很少有临床试验将残疾作为一项结果进行考量，或者关注在这一人群中残疾是否可以得到改善。运动对非癌症老年人群的身体健康和幸福感有多种积极影响，有望作为一种支持性护理干预措施，以改善癌症治疗期间及之后的身体功能和症状。大多数支持运动对癌症幸存者有积极益处的研究都是在较年轻的患者中进行的。针对老年人的有限试验结果表明，体育活动干预对老年癌症幸存者是安全有效的，前列腺癌幸存者是对老年癌症患者研究最多的队列。关于老年患者运动干预的最佳时机、方式、强度和实施方式，仍有许多问题没有答案。虽然现有数据支持运动对老年癌症患者的潜在益处，但建议需要因人而异，以优化参与度、安全性和疗效。
