Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Department of Health Policy and Management and Primary Care for Cancer Survivors Program, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Cancer. 2018 Mar 15;124(6):1279-1287. doi: 10.1002/cncr.31238. Epub 2018 Feb 8.
Fatigue is prevalent and distressing among cancer survivors, but its subjective nature makes it difficult to identify. Fatigability, defined as task-specific fatigue, and endurance performance may be useful supplemental measures of functional status in cancer survivors.
Fatigability, endurance performance, and cancer history were assessed every 2 years in Baltimore Longitudinal Study of Aging participants between 2007 and 2015. Fatigability was defined according to the Borg rating of perceived exertion scale after a 5-minute, slow treadmill walk; and endurance performance was calculated according to the ability and time to complete a fast-paced, 400-meter walk. The association between cancer history, fatigability, and endurance performance was evaluated using longitudinal analyses adjusted for age, sex, body mass index, and comorbidities.
Of 1665 participants, 334 (20%) reported a history of cancer. A combination of older age (>65 years) and a history of cancer was associated with 3.8 and 8.6 greater odds of high perceived fatigability and poor endurance, respectively (P < .01). Older adults with and without a history of cancer walked 42 and 23 seconds slower than younger adults without a history of cancer, respectively (P < .01). The median times to the development of high fatigability and poor endurance were shorter among those who had a history of cancer compared with those who had no history of cancer (P < .01).
The current findings suggest that a history of cancer is associated with fatigability and poor endurance and that this effect is significantly greater in older adults. Evaluating the effects of cancer and age on fatigability may illuminate potential pathways and targets for future interventions. Cancer 2018;124:1279-87. © 2018 American Cancer Society.
疲劳在癌症幸存者中普遍存在且令人痛苦，但由于其主观性，很难确定。疲劳性，即特定任务的疲劳，以及耐力表现，可能是癌症幸存者功能状态的有用补充衡量标准。
2007 年至 2015 年，巴尔的摩纵向老龄化研究的参与者每两年评估一次疲劳性、耐力表现和癌症病史。疲劳性根据 5 分钟慢走后 Borg 感知用力评分量表定义；耐力表现根据快速完成 400 米快走的能力和时间来计算。使用纵向分析，调整年龄、性别、体重指数和合并症，评估癌症病史、疲劳性和耐力表现之间的关联。
在 1665 名参与者中，334 名（20%）报告有癌症病史。年龄较大（>65 岁）和癌症病史的组合与感知疲劳和耐力差的可能性分别增加 3.8 倍和 8.6 倍（P <.01）。有和没有癌症病史的老年人比没有癌症病史的年轻成年人分别慢走 42 秒和 23 秒（P <.01）。与没有癌症病史的人相比，有癌症病史的人出现疲劳和耐力差的中位时间更短（P <.01）。
目前的研究结果表明，癌症病史与疲劳性和耐力差有关，且在老年人中这种影响更为显著。评估癌症和年龄对疲劳性的影响可能阐明未来干预的潜在途径和靶点。癌症 2018;124:1279-87。© 2018 美国癌症协会。
