Bamonti Patricia M, Weiskittle Rachel E, Naik Aanand D, Bean Jonathan F, Moye Jennifer A
Staff Psychologist, New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Brockton, MA; Instructor, Harvard Medical School, Boston, MA.
Advanced Research Fellow, New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Brockton, MA; Advanced Research Fellow, Harvard Medical School, Boston, MA.
Rehabil Oncol. 2021 Oct;39(4):E98-E105. doi: 10.1097/01.reo.0000000000000275.
Cancer survivors are at risk for declines in physical functioning (PF). The strongest predictor of PF is prior PF. Clinically significant depression predicts declines in PF; however, the extent to which depression symptoms moderate the association between self-reported and performance-based measures of PF over time is unknown.
OBJECTIVE/PURPOSE: To examine whether level of depression symptoms in cancer survivors moderates the association of repeated self- and performance-based measures of PF at 6 and 18 months after cancer diagnosis.
Prospective, observational study with assessment at 6 (T1), 12 (T2), and 18 months after cancer diagnosis (T3).
Community-dwelling US veterans with newly diagnosed head and neck, esophageal, gastric, or colorectal cancers.
Measures included demographics, cancer variables (type, stage, severity, and treatment), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), Short Physical Performance Battery (SPPB), and self-reported PF (Patient-Reported Outcomes Measurement Information System-29 [PROMIS-29]).
Using hierarchical regression models, after adjustment for covariates, depression symptoms at T2 moderated the relationship between performance-based PF, SPPB ( = -0.24, = .001) but not self-reported PF, PROMIS ( = -0.14, = .05). In moderation analyses, SPPB T1 was only related to SPPB T3 when the PHQ-9 score was less than 9.
Majority White, male participants, did not measure chronicity of depression.
Depression symptoms moderate the relationship of performance-based PF from baseline to 18 months.
癌症幸存者存在身体功能（PF）下降的风险。PF最强的预测因素是既往PF。具有临床意义的抑郁症可预测PF下降；然而，随着时间的推移，抑郁症状在多大程度上调节了自我报告的PF与基于表现的PF测量之间的关联尚不清楚。
研究癌症幸存者的抑郁症状水平是否调节癌症诊断后6个月和18个月重复的自我报告和基于表现的PF测量之间的关联。
前瞻性观察性研究，在癌症诊断后6个月（T1）、12个月（T2）和18个月（T3）进行评估。
美国社区居住的新诊断为头颈癌、食管癌、胃癌或结直肠癌的退伍军人。
测量指标包括人口统计学、癌症变量（类型、分期、严重程度和治疗）、抑郁症状（患者健康问卷-9[PHQ-9]）、简短身体表现量表（SPPB）和自我报告的PF（患者报告结局测量信息系统-29[PROMIS-29]）。
使用分层回归模型，在调整协变量后，T2时的抑郁症状调节了基于表现的PF（SPPB）之间的关系（β=-0.24，P=.001），但未调节自我报告的PF（PROMIS）之间的关系（β=-0.14，P=.05）。在调节分析中，只有当PHQ-9评分小于9时，SPPB T1才与SPPB T3相关。
大多数为白人男性参与者，未测量抑郁的慢性情况。
抑郁症状调节了从基线到18个月基于表现的PF之间的关系。
