Department of Oncology, Georgetown University School of Medicine, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.
Department of Epidemiology, New York University School of Global Public Health, New York, NY, USA.
Support Care Cancer. 2021 May;29(5):2713-2722. doi: 10.1007/s00520-020-05782-6. Epub 2020 Sep 26.
We aimed to investigate associations of self-rated health with fruit and vegetable consumption (FVC) and physical activity (PA) among older cancer survivors.
We used the 2017 Behavioral Risk Factor Surveillance System to identify cancer survivors ≥ 65 years (N = 2663). Self-reported FVC and PA were categorized as ordinal variables to approximate quartiles. Low general health (LGH) was defined as fair or poor self-rated health. A multivariable logistic regression treating LGH as the outcome was used to calculate adjusted odd ratios (aORs) and 95% confidence intervals (CIs) for FVC and PA. Restricted cubic spline depicted non-linear dose-response curves for FVC and PA. In comparative analysis, we used the same logistic regression and dose-response model to calculate ORs of FVC and PA in 73,134 people ≥ 65 years without cancer history.
Overall, 470 (17.7%) survivors had LGH. Survivors' mean age was 73.3 years (SD = 5.2), 55.1% of them were female, and 95.4% self-reported as white. In cancer survivors, FVC was not associated with LGH (≥ 28 vs. < 14 times/week: aOR = 1.02, 95% CI = 0.75-1.39, p-trend = 0.50), whereas PA was inversely associated with LGH (≥ 30 vs. < 7 MET-hours/week: aOR = 0.55, 95% CI = 0.41-0.75, p-trend < 0.01). Dose-response curves demonstrated consistent association patterns. In comparative analysis, ORs of PA did not change substantially but we observed inverse association for FVC.
An inverse association between PA and LGH was observed among older cancer survivors, but no significant association was obtained for FVC among them. Regular PA may maintain or indicate a favorable health in older cancer survivors, whereas impacts of FVC deserve further investigations.
本研究旨在探讨自我报告的健康状况与老年癌症幸存者水果和蔬菜摄入(FVC)及身体活动(PA)之间的关联。
我们使用 2017 年行为风险因素监测系统(BRFSS)确定年龄≥65 岁的癌症幸存者(N=2663)。自我报告的 FVC 和 PA 被归类为有序变量,以近似四分位数。低总体健康状况(LGH)定义为一般自我报告健康状况为“差”或“差”。采用多变量逻辑回归模型,以 LGH 为因变量,计算 FVC 和 PA 的调整比值比(aOR)和 95%置信区间(CI)。受限三次样条描绘了 FVC 和 PA 的非线性剂量反应曲线。在比较分析中,我们使用相同的逻辑回归和剂量反应模型,计算了 73134 名无癌症病史的年龄≥65 岁人群的 FVC 和 PA 的比值比(OR)。
总体而言,470 名(17.7%)幸存者存在 LGH。幸存者的平均年龄为 73.3 岁(SD=5.2),55.1%为女性,95.4%自我报告为白人。在癌症幸存者中,FVC 与 LGH 无关(≥28 次/周与<14 次/周:aOR=1.02,95%CI=0.75-1.39,p 趋势=0.50),而 PA 与 LGH 呈负相关(≥30 次/周与<7MET-h/周:aOR=0.55,95%CI=0.41-0.75,p 趋势<0.01)。剂量反应曲线显示出一致的关联模式。在比较分析中,PA 的 OR 没有显著变化,但我们观察到 FVC 呈负相关。
在老年癌症幸存者中,PA 与 LGH 呈负相关,但两者之间不存在显著关联。有规律的 PA 可能维持或表明老年癌症幸存者的健康状况良好,而 FVC 的影响值得进一步研究。