Winters-Stone Kerri M, Moe Esther, Graff Julie N, Dieckmann Nathan F, Stoyles Sydnee, Borsch Carolyn, Alumkal Joshi J, Amling Christopher L, Beer Tomasz M
Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon.
School of Nursing, Oregon Health & Science University, Portland, Oregon.
J Am Geriatr Soc. 2017 Jul;65(7):1414-1419. doi: 10.1111/jgs.14795. Epub 2017 Mar 6.
To compare the prevalence of and association between falls and frailty of prostate cancer survivors (PCSs) who were current, past or never users of androgen deprivation therapy (ADT).
Cross-sectional.
Mail and electronic survey.
PCSs (N = 280; mean age 72 ± 8).
Cancer history, falls, and frailty status (robust, prefrail, frail) using traditionally defined and obese phenotypes.
Current (37%) or past (34%) ADT users were more than twice as likely to have fallen in the previous year as never users (15%) (P = .002). ADT users had twice as many recurrent falls (P < .001) and more fall-related injuries than unexposed men (P = .01). Current (43%) or past (40%) ADT users were more likely to be classified as prefrail or frail than never users (15%) (P < .001), and the prevalence of combined obese frailty + prefrailty was even greater in current (59%) or past (62%) ADT users than never users (25%) (P < .001). Traditional and obese frailty significantly increased the likelihood of reporting falls in the previous year (odds ratio (OR) = 2.15, 95% CI = 1.18-3.94 and OR = 2.97, 95% CI = 1.62-5.58, respectively) and was also associated with greater risk of recurrent falls (OR = 3.10, 95% CI = 1.48-6.5 and OR = 3.99, 95% CI = 1.79-8.89, respectively).
Current and past exposure to ADT is linked to higher risk of falls and frailty than no treatment. PCSs should be appropriately counseled on fall prevention strategies, and approaches to reduce frailty should be considered.
比较正在接受、曾经接受或从未接受雄激素剥夺治疗（ADT）的前列腺癌幸存者（PCSs）跌倒的发生率以及跌倒与虚弱之间的关联。
横断面研究。
邮件和电子调查。
PCSs（N = 280；平均年龄72±8岁）。
使用传统定义和肥胖表型评估癌症病史、跌倒情况和虚弱状态（强健、脆弱前期、虚弱）。
当前（37%）或曾经（34%）接受ADT治疗的患者上一年跌倒的可能性是从未接受治疗患者（15%）的两倍多（P = 0.002）。与未接受ADT治疗的男性相比，接受ADT治疗的患者跌倒复发次数是其两倍（P < 0.001），且跌倒相关损伤更多（P = 0.01）。当前（43%）或曾经（40%）接受ADT治疗的患者比从未接受治疗的患者（15%）更有可能被归类为脆弱前期或虚弱（P < 0.001），当前（59%）或曾经（62%）接受ADT治疗的患者中肥胖合并虚弱前期 + 虚弱前期的患病率甚至高于从未接受治疗的患者（25%）（P < 0.001）。传统虚弱和肥胖虚弱显著增加了上一年报告跌倒的可能性（优势比（OR）分别为2.15，95%置信区间 = 1.18 - 3.94和OR = 2.97，95%置信区间 = 1.62 - 5.58），并且也与跌倒复发的更高风险相关（OR分别为3.10，95%置信区间 = 1.48 - 6.5和OR = 3.99，95%置信区间 = 1.79 - 8.89）。
与未接受治疗相比，当前和曾经接受ADT治疗与更高的跌倒风险和虚弱风险相关。应对PCSs进行关于跌倒预防策略的适当咨询，并应考虑采取减轻虚弱的方法。
