School of Nursing, Peking University, Beijing 100191, China.
Neurology Department, Guizhou Provincial People's Hospital, Guiyang 550002, China.
Age Ageing. 2023 Oct 2;52(10). doi: 10.1093/ageing/afad190.
Frailty is a dynamic process associated with adverse health outcomes. However, little is known about the long-term trajectories of frailty in older cancer survivors.
To describe the trajectories of frailty phenotype over time amongst older cancer survivors and examine the socio-demographic and health-related predictors of different trajectories.
Population-based longitudinal cohort study.
Community-dwelling older adults in the United States.
1,763 older adults who were diagnosed with cancer from the National Health and Ageing Trends Study.
Frailty was assessed by the Fried Frailty Phenotype. The group-based trajectory model was used to identify the trajectories of frailty. Multinomial logistic regression analyses were used to examine the socio-demographic and health-related predictors of different trajectories.
Three frailty trajectories were identified; 52.8% of older cancer survivors had a sustained low risk of frailty over time, 25.0% had a low frailty risk at baseline but the risk increased steadily, and 22.3% had a high frailty risk with a slight change in the observed period. Older cancer survivors were at a high-risk frailty trajectory if they were older, female, African American, had lower education status, had lower annual income, were underweight or obese, self-rated poorer health, had more chronic conditions and difficulties with activities of daily living (ADL), and had worse cognitive functions (P < 0.05).
Long-term frailty trajectories in older cancer survivors are heterogeneous. This study helps identify patients at high risk of sustained or deteriorating frailty and has the potential to inform targeted frailty management strategies addressing modifiable factors identified (e.g. body mass index, ADL).
衰弱是与不良健康结局相关的动态过程。然而，对于老年癌症幸存者衰弱的长期轨迹知之甚少。
描述老年癌症幸存者衰弱表型随时间的变化轨迹，并探讨不同轨迹的社会人口统计学和健康相关预测因素。
基于人群的纵向队列研究。
美国社区居住的老年人。
来自国家健康与老龄化趋势研究的 1763 名被诊断患有癌症的老年人。
使用 Fried 衰弱表型评估衰弱。使用基于群组的轨迹模型来确定衰弱的轨迹。使用多项逻辑回归分析来检验不同轨迹的社会人口统计学和健康相关预测因素。
确定了 3 种衰弱轨迹；52.8%的老年癌症幸存者在较长时间内一直处于低衰弱风险状态，25.0%的基线衰弱风险较低，但风险稳步增加，22.3%的基线衰弱风险较高，观察期间略有变化。如果老年癌症幸存者年龄较大、女性、非裔美国人、教育程度较低、年收入较低、体重过轻或肥胖、自我评估健康状况较差、患有更多慢性疾病且日常生活活动（ADL）困难，以及认知功能较差，他们处于高风险衰弱轨迹（P<0.05）。
老年癌症幸存者的长期衰弱轨迹存在异质性。本研究有助于识别持续或恶化衰弱的高风险患者，并有可能为针对可改变因素（如体重指数、ADL）的靶向衰弱管理策略提供信息。
