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针对老年癌症患者的身体活动和营养干预措施:系统评价。

Physical activity and nutrition interventions for older adults with cancer: a systematic review.

机构信息

Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Kingston-Upon-Hull, UK.

University of Hull, Allam Medical Building 3rd Floor, Cottingham Road, Kingston-Upon-Hull, East Yorkshire, HU6 7RX, UK.

出版信息

J Cancer Surviv. 2020 Oct;14(5):689-711. doi: 10.1007/s11764-020-00883-x. Epub 2020 Apr 24.

Abstract

PURPOSE

The aim of this review was to summarize the current literature for the effectiveness of activity and nutritional based interventions on health-related quality of life (HRQoL) in older adults living with and beyond cancer (LWBC).

METHODS

We conducted systematic structured searches of CINAHL, Embase, Medline, Cochrane CENTRAL databases, and bibliographic review. Two independent researchers selected against inclusion criteria: (1) lifestyle nutrition and/or activity intervention for people with any cancer diagnosis, (2) measured HRQoL, (3) all participants over 60 years of age and (4) randomized controlled trials.

RESULTS

Searches identified 5179 titles; 114 articles had full text review, with 14 studies (participant n = 1660) included. Three had nutrition and activity components, one, nutrition only and ten, activity only. Duration ranged from 7 days to 1 year. Interventions varied from intensive daily prehabilitation to home-based gardening interventions. Studies investigated various HRQoL outcomes including fatigue, general and cancer-specific quality of life (QoL), distress, depression, global side-effect burden and physical functioning. Eight studies reported significant intervention improvements in one or more QoL measure. Seven studies reported using a psychosocial/theoretical framework. There is a gap in tailored nutrition advice.

CONCLUSIONS

Among the few studies that targeted older adults with cancer, most were activity-based programmes with half reporting improvements in QoL. Future research should focus on or include tailored nutrition components and consider appropriate behaviour change techniques to maximize potential QoL improvement.

IMPLICATIONS FOR CANCER SURVIVORS

More research is needed to address the research gap regarding older adults as current recommendations are derived from younger populations.

摘要

目的

本综述的目的是总结目前关于针对癌症存活者和癌症康复者(LWBC)的基于活动和营养的干预措施对健康相关生活质量(HRQoL)的有效性的文献。

方法

我们对 CINAHL、Embase、Medline、Cochrane 中心数据库进行了系统的结构化检索,并进行了文献回顾。两名独立的研究人员根据纳入标准进行了筛选:(1)针对任何癌症诊断患者的生活方式营养和/或活动干预;(2)测量 HRQoL;(3)所有参与者年龄均超过 60 岁;(4)随机对照试验。

结果

搜索共确定了 5179 篇标题;对 114 篇文章进行了全文审查,其中 14 项研究(参与者 n=1660)入选。其中 3 项研究包含营养和活动成分,1 项研究仅包含营养成分,10 项研究仅包含活动成分。干预时间从 7 天到 1 年不等。干预措施从强化日常康复治疗到家庭园艺干预不等。研究调查了各种 HRQoL 结果,包括疲劳、一般和癌症特异性生活质量(QoL)、困扰、抑郁、全身副作用负担和身体功能。8 项研究报告了一项或多项 QoL 测量指标的显著干预改善。7 项研究报告了使用心理社会/理论框架。在量身定制的营养建议方面存在差距。

结论

在针对癌症老年患者的少数研究中,大多数是基于活动的方案,其中一半报告 QoL 得到改善。未来的研究应重点关注或纳入量身定制的营养成分,并考虑适当的行为改变技术,以最大限度地提高潜在的 QoL 改善。

对癌症幸存者的影响

需要更多的研究来解决针对老年人群的研究差距,因为目前的建议是基于年轻人群得出的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f743/7473955/12a265c5bcbb/11764_2020_883_Fig1_HTML.jpg

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