Ehlers D K, Weaver N, Ma J, Mama S K, Page L L, Rowland J, Arem H
Department of Quantitative Health Sciences, Health Futures Center, Mayo Clinic, 6161 E. Mayo Blvd, Phoenix, AZ, 85054, USA.
Department of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
J Cancer Surviv. 2024 Jul 31. doi: 10.1007/s11764-024-01638-8.
Using data from the National Health Interview Survey (NHIS), this study examined the odds of functional limitations across nine domains by cancer status (with vs. without cancer history) and age group (18-44, 45-64, 65 + years).
Participants were 151,509 adults in the 2014-2018 NHIS. Functional limitations included self-reported difficulty conducting nine activities. Data were analyzed using age-stratified multivariate logistic regression (no limitation vs. limited in any way; minor limitation vs. major limitation) and are reported as covariate-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs). To gather insight on the influence of cancer, compared to aging without a history of cancer, on functional limitations, we also conducted exploratory regression analyses comparing all cancer by age groups to 18-44 year-olds without a cancer history.
Cancer survivors (n = 12,518) were more likely to report a limitation than adults without cancer (n = 138,991). Age-stratified ORs for 1 + limitation were 2.75 (95% CI 1.98, 3.81) among 18-44 year-olds, 2.42 (95% CI 2.00, 2.93) among 45-64 year-olds, and 1.59 (95% CI 1.39, 1.82) among 65 + year-olds. Cancer survivors were more likely to report major limitations across multiple domains, with age-stratified ORs ranging from 1.18 (65 + year-olds, stooping limitation) to 2.28 (18-44 year-old, sitting limitation). ORs from exploratory analyses were lowest among 45-64 year-old adults without a cancer history (2.69-4.42) and highest among older adult cancer survivors (3.42-14.73).
Cancer was associated with limitations across age groups, with the highest age-stratified ORs observed among younger adults and for mobility and lower-extremity limitations. Stronger efforts to assess limitations as part of routine care and implement targeted interventions to address limitations are needed.
Functional limitations have been linked with poorer aging trajectories and lower quality of life in cancer and non-cancer populations. Routine screening to identify and discuss functional limitations with cancer patients may help reduce the burden of such limitations on survivors.
本研究利用美国国家健康访谈调查（NHIS）的数据，按癌症状态（有与无癌症病史）和年龄组（18 - 44岁、45 - 64岁、65岁及以上）分析了九个领域功能受限的几率。
研究对象为2014 - 2018年NHIS中的151,509名成年人。功能受限包括自我报告的进行九项活动时存在困难。数据采用年龄分层多因素逻辑回归分析（无受限与任何形式的受限；轻度受限与重度受限），结果以协变量调整后的优势比（OR）和95%置信区间（95%CI）表示。为深入了解癌症（与无癌症病史的衰老相比）对功能受限的影响，我们还进行了探索性回归分析，将各年龄组的所有癌症患者与无癌症病史的18 - 44岁人群进行比较。
癌症幸存者（n = 12,518）比无癌症的成年人（n = 138,991）更有可能报告功能受限。18 - 44岁人群中，存在1项及以上功能受限的年龄分层OR为2.75（95%CI 1.98, 3.81）；45 - 64岁人群中为2.42（95%CI 2.00, 2.93）；65岁及以上人群中为1.59（95%CI 1.39, 1.82）。癌症幸存者更有可能报告多个领域的重度功能受限，年龄分层OR范围从1.18（65岁及以上人群，弯腰受限）到2.28（18 - 44岁人群，坐姿受限）。探索性分析的OR在无癌症病史的45 - 64岁成年人中最低（2.69 - 4.42），在老年癌症幸存者中最高（3.42 - 14.73）。
癌症与各年龄组的功能受限相关，在较年轻成年人中以及在活动能力和下肢受限方面观察到最高的年龄分层OR。需要加大力度在常规护理中评估功能受限情况，并实施针对性干预措施以解决功能受限问题。
功能受限与癌症和非癌症人群中较差的衰老轨迹及较低的生活质量相关。对癌症患者进行常规筛查以识别并讨论功能受限情况，可能有助于减轻幸存者此类受限的负担。
