Weaver Kathryn E, Leach Corinne R, Leng Xiaoyan, Danhauer Suzanne C, Klepin Heidi D, Vaughan Leslie, Naughton Michelle, Chlebowski Rowan T, Vitolins Mara Z, Paskett Electra
Wake Forest School of Medicine, Department of Social Sciences and Health Policy, Winston-Salem, North Carolina.
The American Cancer Society, Behavioral Research Center Atlanta, GA.
J Gerontol A Biol Sci Med Sci. 2016 Mar;71 Suppl 1(Suppl 1):S23-30. doi: 10.1093/gerona/glv073.
Females 80 years and older comprise 22% of the total U.S. survivor population, yet the impact of cancer on the physical well-being of women is this age group has not been well characterized.
We compared women, 80 years of age and older in the Women's Health Initiative extension 2, who did (n = 2,270) and did not (n = 20,272) have an adjudicated history of cancer during Women's Health Initiative enrollment; analyses focused on women >2-years postcancer diagnosis. The physical functioning subscale of the RAND-36 was the primary outcome. Demographic, health-status, and psychosocial covariates were drawn from Women's Health Initiative assessments. Analysis of covariance was used to examine the effect of cancer history on physical function, with and without adjustment for covariates.
In adjusted models, women with a history of cancer reported significantly lower mean physical functioning (56.6, standard error [SE] 0.4) than those without a cancer history (58.0, SE 0.1), p = .002. In these models, younger current age, lower body mass index, increased physical activity, higher self-rated health, increased reported happiness, and the absence of noncancer comorbid conditions were all associated with higher physical functioning in both women with and without a history of cancer.
Women older than 80 years of age with a cancer history have only a moderately lower level of physical function than comparably aged women without a cancer history. Factors associated with higher levels of physical functioning were similar in both groups.
80岁及以上的女性占美国幸存者总人口的22%，然而癌症对这个年龄组女性身体健康的影响尚未得到充分描述。
我们比较了妇女健康倡议扩展2中80岁及以上的女性，其中有（n = 2270）和没有（n = 20272）在妇女健康倡议登记期间经判定的癌症病史；分析重点关注癌症诊断后2年以上的女性。兰德36项健康调查的身体功能分量表是主要结果。人口统计学、健康状况和社会心理协变量来自妇女健康倡议评估。采用协方差分析来检验癌症病史对身体功能的影响，包括调整和未调整协变量的情况。
在调整模型中，有癌症病史的女性报告的平均身体功能（56.6，标准误[SE]0.4）显著低于无癌症病史的女性（58.0，SE 0.1），p = 0.002。在这些模型中，当前年龄较小、体重指数较低、身体活动增加、自我评估健康状况较高、报告的幸福感增加以及无癌症合并症均与有和无癌症病史的女性较高的身体功能相关。
有癌症病史的80岁以上女性的身体功能水平仅比无癌症病史的同龄女性略低。两组中与较高身体功能水平相关的因素相似。
