Brown Justin C, Yang Shengping
AdventHealth, Orlando, FL 32804, United States.
Pennington Biomedical Research Center, Baton Rouge, LA 70808, United States.
JNCI Cancer Spectr. 2025 Sep 1;9(5). doi: 10.1093/jncics/pkaf084.
Cancer survivors may be more likely to experience accelerated declines in physical function compared to cancer-free controls, but objective data and knowledge of preventive interventions are limited.
The Lifestyle Interventions and Independence for Elders (LIFE) study was a multicenter, single-blinded, randomized trial conducted at 8 centers across the United States that enrolled 1635 sedentary adults aged 70-89 years and with physical limitations but who could walk 400 m at baseline, of which 371 (22.7%) reported a history of cancer. Participants were randomized in a 1:1 ratio to a health education or physical activity program. The primary endpoint was time to major mobility disability, defined objectively by the inability to walk 400 m in less than 15 minutes.
Cancer history modified the effect of randomized group on major mobility disability (P = .006). Among those randomized to the health education program, participants with a history of cancer were 53% more likely to develop major mobility disability compared with participants who did not have a history of cancer (Hazard Ratio (HR) = 1.53; 95% CI = 1.18 to 1.99; P = .001). Among participants with a history of cancer, those randomized to the physical activity program were 43% less likely to develop major mobility disability compared with the health education program (HR = 0.57; 95% CI = 0.40 to 0.82; P = .003).
In this analysis of a randomized clinical trial, cancer survivors had an increased risk of mobility disability compared with non-cancer controls, and physical activity attenuated this risk.
与未患癌症的对照组相比,癌症幸存者的身体功能可能更易加速衰退,但客观数据和预防性干预措施的相关知识有限。
老年人生活方式干预与独立性(LIFE)研究是一项在美国8个中心开展的多中心、单盲、随机试验,纳入了1635名年龄在70 - 89岁、久坐不动且有身体功能限制但在基线时能行走400米的成年人,其中371人(22.7%)报告有癌症病史。参与者按1:1比例随机分配至健康教育或体育活动项目组。主要终点是发生严重活动障碍的时间,客观定义为无法在15分钟内行走400米。
癌症病史改变了随机分组对严重活动障碍的影响(P = 0.006)。在随机分配至健康教育项目组的人群中,有癌症病史的参与者发生严重活动障碍的可能性比无癌症病史的参与者高53%(风险比(HR)= 1.53;95%置信区间 = 1.18至1.99;P = 0.001)。在有癌症病史的参与者中,随机分配至体育活动项目组的人发生严重活动障碍的可能性比健康教育项目组低43%(HR = 0.57;95%置信区间 = 0.40至0.82;P = 0.003)。
在这项随机临床试验分析中,与非癌症对照组相比,癌症幸存者发生活动障碍的风险增加,而体育活动可降低这一风险。