Satariano W A, Ragland D R
Division of Public Health Biology and Epidemiology, School of Public Health, University of California at Berkeley, USA.
J Gerontol A Biol Sci Med Sci. 1996 Sep;51(5):M215-9. doi: 10.1093/gerona/51a.5.m215.
In most studies of functional limitations in women with breast cancer, it is difficult to determine what difficulties are associated with breast cancer and what problems are likely to be found in women of the same age without the disease. In the present study, we report the age-specific prevalence of upper-body limitations in women with breast cancer over the course of one year, compared to that experienced by women of the same age without the disease.
Interviews were conducted with women with breast cancer ages 40-84 at 3 months (n = 934) and 12 months after diagnosis (n = 843). Controls were interviewed twice over the same period (n = 991 and 887, respectively). The main outcome was upper-body limitation, defined as the number of tasks requiring upper-body strength (0-4) reported by the respondent to be very difficult to complete or not done on doctor's orders.
Cases ages 40-54, 55-64, and 65-74 were approximately twice as likely as age-matched controls to report upper-body limitations, adjusting for race, education, financial status, and comorbidity. There was no case/control difference among those ages 75-84. At one year, the breast cancer patients ages 40-54 and 55-64 showed the greatest improvement.
Many women who survive breast cancer report significant limitations in upper-body strength in the first few months, followed, especially among younger women, by a period of recuperation. Rehabilitation and home-care programs should be designed to meet the special and more persistent needs of older women. New strategies for assessing upper-body strength are also suggested.
在大多数关于乳腺癌女性功能受限的研究中,很难确定哪些困难与乳腺癌相关,以及在同年龄段未患该病的女性中可能会出现哪些问题。在本研究中,我们报告了乳腺癌女性在一年时间里上半身功能受限的年龄特异性患病率,并与同年龄段未患该病的女性进行了比较。
对年龄在40 - 84岁的乳腺癌女性在诊断后3个月(n = 934)和12个月(n = 843)进行访谈。对照组在同一时期接受两次访谈(分别为n = 991和887)。主要结局是上半身功能受限,定义为被调查者报告因需要上半身力量而非常难以完成或根据医嘱未完成的任务数量(0 - 4项)。
在调整种族、教育程度、经济状况和合并症后,40 - 54岁、55 - 64岁和65 - 74岁的病例报告上半身功能受限的可能性大约是年龄匹配对照组的两倍。75 - 84岁的病例与对照组之间没有差异。在一年时,40 - 54岁和55 - 64岁的乳腺癌患者改善最为明显。
许多乳腺癌幸存者在最初几个月报告上半身力量存在显著受限,尤其是年轻女性随后会经历一段恢复期。应设计康复和家庭护理计划,以满足老年女性特殊且更持久的需求。还提出了评估上半身力量的新策略。