Tibbitts Deanne C, Mancini Martina, Stoyles Sydnee, Dieckmann Nathan F, Graff Julie N, El-Gohary Mahmoud, Horak Fay B, Winters-Stone Kerri M
Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA.
Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
J Geriatr Oncol. 2025 Mar;16(2):102180. doi: 10.1016/j.jgo.2024.102180. Epub 2024 Dec 20.
Androgen deprivation therapy (ADT) increases the risk of frailty, falls, and poor physical functioning in older adults with prostate cancer. Detection of frailty is limited to self-report instruments and performance measures, so unbiased tools are needed. We investigated relationships between an unbiased measure - daily life mobility - and ADT history, frailty, fall history, and functioning in older prostate cancer survivors treated with ADT.
This cross-sectional study recruited prostate cancer survivors with a history of ADT from an exercise clinical trial, an academic medical center, and the community. Participants completed performance measures and surveys to assess frailty, fall history, and physical functioning, then wore instrumented socks for up to seven days to continuously monitor daily life mobility. We performed a principal component analysis on daily life mobility metrics and used regression analyses to investigate relationships between domains of daily life mobility and frailty, fall history, and physical functioning.
Participants (N = 99) were aged 73.0 +/- 7.3 years, most were pre-frail or frail (75 %), and 35 % had fallen at least once in the last year. Daily life mobility metrics clustered into four domains: Gait Pace, Rhythm, Activity, and Balance. Worse scores on Rhythm and Activity were associated with increased odds of frailty (odds ratio [OR] 1.59, 95 % confidence interval [CI]: 1.04, 2.49 and OR 1.81, 95 % CI: 1.19, 2.83, respectively). A worse score on Rhythm was associated with increased odds of ≥1 falls in the previous year (OR 1.60, 95 % CI: 1.05, 2.47). Worse scores on Gait Pace, Rhythm, and Activity were associated with worse physical functioning. Mobility metrics were similar between current and past users of ADT.
Continuous passive monitoring of daily life mobility may identify prostate cancer survivors who have developed frailty, falls, and declines in physical functioning.
雄激素剥夺疗法（ADT）会增加老年前列腺癌患者出现身体虚弱、跌倒及身体功能不佳的风险。目前对身体虚弱的检测仅限于自我报告工具和表现测量，因此需要无偏差的工具。我们研究了一种无偏差测量方法——日常生活活动能力——与ADT治疗史、身体虚弱、跌倒史以及接受ADT治疗的老年前列腺癌幸存者身体功能之间的关系。
这项横断面研究从一项运动临床试验、一家学术医疗中心和社区招募了有ADT治疗史的前列腺癌幸存者。参与者完成表现测量和调查以评估身体虚弱、跌倒史和身体功能，然后穿着装有仪器的袜子长达7天以持续监测日常生活活动能力。我们对日常生活活动能力指标进行了主成分分析，并使用回归分析来研究日常生活活动能力各领域与身体虚弱、跌倒史和身体功能之间的关系。
参与者（N = 99）年龄为73.0±7.3岁，大多数为虚弱前期或虚弱状态（75%），35%在过去一年中至少跌倒过一次。日常生活活动能力指标聚类为四个领域：步速、节奏、活动和平衡。节奏和活动方面得分越差，身体虚弱的几率越高（优势比[OR]分别为1.59，95%置信区间[CI]：1.04，2.49和OR 1.81，95%CI：1.19，2.83）。节奏方面得分越差，前一年发生≥1次跌倒的几率越高（OR 1.60，95%CI：1.05，2.47）。步速、节奏和活动方面得分越差，身体功能越差。ADT当前使用者和过去使用者之间的活动能力指标相似。
对日常生活活动能力进行持续被动监测可能有助于识别已出现身体虚弱、跌倒及身体功能下降的前列腺癌幸存者。
