Pergolotti Mackenzi, Deal Allison M, Williams Grant R, Bryant Ashley L, Bensen Jeannette T, Muss Hyman B, Reeve Bryce B
Department of Occupational Therapy, College of Health and Human Services, Colorado State University, 800 Oval Drive, Fort Collins, CO 80526, USA.
Biostatistics Core Facility, The University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer Center, 170 Manning Drive, Chapel Hill, NC 27599, USA.
J Geriatr Oncol. 2017 Jul;8(4):249-254. doi: 10.1016/j.jgo.2017.02.009. Epub 2017 Mar 9.
This study aims to (1) describe the activities, function, and health-related quality of life (HRQOL) of a large sample of older adults (age ≥65) with cancer, (2) identify the associations with demographics, cancer type, comorbid conditions, and ability to participate in activities and functional status.
The Health Registry/Cancer Survivorship Cohort is an institutional database designed to aid cancer survivorship research. The registry includes three measures of patient-reported HRQOL: FACT-G and PROMIS® Global measures for physical and mental health. Other measures included in the registry are cancer type, date from diagnosis, number of comorbid conditions and specific conditions and their limitations in daily activity, and self-reported daily activity/function.
Our sample consists of 768 older adults with cancer, mean age 72years, 60% female, and 90% White. Mean scores for HRQOL: FACT-G (85, range: 25-108), PROMIS-physical (48, range: 16-67) and, PROMIS-mental (51, range: 21-67). In multivariable models, Black race, one or more comorbid conditions, and Gastrointestinal cancer (p<.05), and patient- reported decreased levels of activities/function were all independently associated with poor HRQOL (p<.0001).
Older Black adults with cancer, those that have high comorbidity burden, with gastrointestinal cancers and those that report decreased ability to participate in daily activities/function reported poorer HRQOL. As geriatric oncology moves towards trying to identify who may need supportive services, this study demonstrated that a one question patient-reported level of activities and functional ability were independently associated with physical, mental, and cancer-specific HRQOL.
本研究旨在（1）描述大量老年癌症患者（年龄≥65岁）的活动、功能及健康相关生活质量（HRQOL），（2）确定其与人口统计学特征、癌症类型、合并症以及参与活动的能力和功能状态之间的关联。
健康登记处/癌症幸存者队列是一个旨在辅助癌症幸存者研究的机构数据库。该登记处包括三项患者报告的HRQOL指标：FACT - G以及用于身心健康的PROMIS®全球指标。登记处纳入的其他指标包括癌症类型、诊断日期、合并症数量及具体病症及其对日常活动的限制，以及自我报告的日常活动/功能。
我们的样本包括768名老年癌症患者，平均年龄72岁，60%为女性，90%为白人。HRQOL的平均得分：FACT - G（85分，范围：25 - 108分），PROMIS - 身体（48分，范围：16 - 67分），PROMIS - 心理（51分，范围：21 - 67分）。在多变量模型中，黑人种族、一种或多种合并症、胃肠道癌症（p <.05）以及患者报告的活动/功能水平下降均与较差的HRQOL独立相关（p <.0001）。
患有癌症的老年黑人、合并症负担重的患者、患有胃肠道癌症的患者以及报告参与日常活动/功能能力下降的患者，其HRQOL较差。随着老年肿瘤学朝着试图确定哪些人可能需要支持性服务的方向发展，本研究表明，患者报告的一个关于活动水平和功能能力的问题与身体、心理及癌症特异性HRQOL独立相关。
