Pandya Chintan, Magnuson Allison, Dale William, Lowenstein Lisa, Fung Chunkit, Mohile Supriya G
Division of Health Policy and Outcomes Research, Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.
Division of Medical Oncology, James Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY, USA.
J Geriatr Oncol. 2016 May;7(3):201-10. doi: 10.1016/j.jgo.2016.01.007. Epub 2016 Feb 18.
To examine the association between falls and health-related quality of life (HRQOL) in older cancer survivors.
Using the 2006-2011 Surveillance, Epidemiology, and End Results cancer registry system and the Medicare Health Outcomes Survey (SEER-MHOS) linkage database, a cross-sectional analysis was performed including 17,958 older cancer survivors. Multivariable regression models were used to evaluate the association of falls with HRQOL measured by the physical component summary (PCS) and mental component summary (MCS) scores on the Veteran RAND 12-item health survey after controlling for demographic, health- and cancer-related factors. A longitudinal analysis using the analysis of covariance (ANCOVA) models was also conducted comparing changes in HRQOL of older cancer survivors who fell with HRQOL of older patients with cancer who did not fall.
In the cross-sectional analysis, 4524 (25%) cancer survivors who fell reported a significantly lower PCS (-2.18; SE=0.16) and MCS (2.00; SE=0.17) scores compared to those who did not (N=13,434). In the longitudinal analysis, after adjusting for baseline HRQOL scores and covariates, patients who fell reported a decline in mean HRQOL scores of both PCS (-1.54; SE=0.26) and MCS (-1.71; SE=0.27). Presence of depression, functional impairment and comorbidities was significantly associated with lower HRQOL scores.
Falls are associated with lower HRQOL scores and are associated with a significant prospective decline in HRQOL in older cancer survivors. Further research is necessary to determine if assessment and intervention programs can help improve HRQOL by reducing the likelihood of falls.
探讨老年癌症幸存者跌倒与健康相关生活质量(HRQOL)之间的关联。
利用2006 - 2011年监测、流行病学和最终结果癌症登记系统以及医疗保险健康结果调查(SEER - MHOS)链接数据库,对17958名老年癌症幸存者进行了横断面分析。在控制了人口统计学、健康和癌症相关因素后,使用多变量回归模型评估跌倒与通过退伍军人兰德12项健康调查的身体成分总结(PCS)和心理成分总结(MCS)得分所衡量的HRQOL之间的关联。还进行了一项纵向分析,使用协方差分析(ANCOVA)模型比较跌倒的老年癌症幸存者与未跌倒的老年癌症患者的HRQOL变化。
在横断面分析中,与未跌倒的癌症幸存者(N = 13434)相比,4524名(25%)跌倒的癌症幸存者报告的PCS得分(-2.18;标准误 = 0.16)和MCS得分(-2.00;标准误 = 0.17)显著更低。在纵向分析中,在调整基线HRQOL得分和协变量后,跌倒的患者报告PCS(-1.54;标准误 = 0.26)和MCS(-1.71;标准误 = 0.27)的平均HRQOL得分均下降。抑郁、功能障碍和合并症的存在与较低的HRQOL得分显著相关。
跌倒与较低的HRQOL得分相关,并且与老年癌症幸存者HRQOL的显著前瞻性下降相关。有必要进行进一步研究以确定评估和干预项目是否可以通过降低跌倒的可能性来帮助改善HRQOL。