Wei Duan-Porter1, Harvey J Cohen2, Wendy Demark-Wahnefried3, Richard Sloane4, Jane F Pendergast5, Denise C Snyder6, Miriam C Morey2. 1. Health Services Research and Development, Durham VA Medical Center, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA. Electronic address: wei.duan-porter@duke.edu. 2. Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA; Duke University Center for the Study of Aging and Human Development, Durham, NC, USA; Geriatrics Research, Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA. 3. Department of Preventive Medicine, Department of Nutrition Sciences, University of Alabama, Birmingham, AL, USA; Comprehensive Cancer Center, University of Alabama, Birmingham, AL, USA. 4. Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA; Duke University Center for the Study of Aging and Human Development, Durham, NC, USA; Geriatrics Research, Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA. 5. Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA; Duke University Center for the Study of Aging and Human Development, Durham, NC, USA; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA. 6. Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA.
Abstract
OBJECTIVES: To characterize factors contributing to physical resilience in older cancer survivors, as demonstrated by resistance to decline or recovery (resilience). MATERIALS AND METHODS: We conducted a secondary analysis of data from a randomized controlled trial of cancer survivors ≥65years old and ≥5years from cancer diagnoses. Physical function was assessed quarterly over 2years, with Short-Form 36 physical function subscale. Participants with ≥2 follow-up assessments (n=594) were evaluated for physical resilience: 1) Resistance was defined as lack of any decline, where decline was a drop of ≥13 points, and 2) resilience (i.e., recovery) was defined as regaining ≥50% of lost function, subsequent to decline. RESULTS:Mean age was 73.1years and 89.1% were Caucasian. Forty-nine percent (n=289) were resistant to decline in function; these individuals were younger, had higher education and income, were more likely to be Caucasian, and had higher baseline physical function (mean difference [MD] 7.8 points, 95% CI 5.0-10.8) and general health (MD 7.5 points, 95% CI 4.9-10.1). Fifty-seven percent (n=137 of 239) demonstrated resilience, with 91.2% (n=125) recovering within 6months of declines; these participants had higher baseline physical function (MD 6.6 points, 95% CI 1.8-11.4), but similar pre-decline function. More participants who were resistant, and more who showed resilience, reported high self-efficacy and social support. CONCLUSIONS: The majority of older cancer survivors exhibited physical resilience; this was associated with high baseline health, physical function, self-efficacy, and social support. Assessing and targeting psychosocial factors may be important for interventions seeking to promote physical resilience. Published by Elsevier Ltd.
RCT Entities:
OBJECTIVES: To characterize factors contributing to physical resilience in older cancer survivors, as demonstrated by resistance to decline or recovery (resilience). MATERIALS AND METHODS: We conducted a secondary analysis of data from a randomized controlled trial of cancer survivors ≥65years old and ≥5years from cancer diagnoses. Physical function was assessed quarterly over 2years, with Short-Form 36 physical function subscale. Participants with ≥2 follow-up assessments (n=594) were evaluated for physical resilience: 1) Resistance was defined as lack of any decline, where decline was a drop of ≥13 points, and 2) resilience (i.e., recovery) was defined as regaining ≥50% of lost function, subsequent to decline. RESULTS: Mean age was 73.1years and 89.1% were Caucasian. Forty-nine percent (n=289) were resistant to decline in function; these individuals were younger, had higher education and income, were more likely to be Caucasian, and had higher baseline physical function (mean difference [MD] 7.8 points, 95% CI 5.0-10.8) and general health (MD 7.5 points, 95% CI 4.9-10.1). Fifty-seven percent (n=137 of 239) demonstrated resilience, with 91.2% (n=125) recovering within 6months of declines; these participants had higher baseline physical function (MD 6.6 points, 95% CI 1.8-11.4), but similar pre-decline function. More participants who were resistant, and more who showed resilience, reported high self-efficacy and social support. CONCLUSIONS: The majority of older cancer survivors exhibited physical resilience; this was associated with high baseline health, physical function, self-efficacy, and social support. Assessing and targeting psychosocial factors may be important for interventions seeking to promote physical resilience. Published by Elsevier Ltd.
Entities:
Keywords:
Cancer survivors; Functional decline; Physical resilience; Recovery; Resistance
Authors: Cynthia M Boyd; Michelle Ricks; Linda P Fried; Jack M Guralnik; Qian-Li Xue; Jin Xia; Karen Bandeen-Roche Journal: J Am Geriatr Soc Date: 2009-08-20 Impact factor: 5.562
Authors: L F Berkman; T E Seeman; M Albert; D Blazer; R Kahn; R Mohs; C Finch; E Schneider; C Cotman; G McClearn Journal: J Clin Epidemiol Date: 1993-10 Impact factor: 6.437
Authors: Arti Hurria; Enrique Soto-Perez-de-Celis; Jacob B Allred; Harvey Jay Cohen; Anait Arsenyan; Karla Ballman; Jennifer Le-Rademacher; Aminah Jatoi; Julie Filo; Jeanne Mandelblatt; Jacqueline M Lafky; Gretchen Kimmick; Heidi D Klepin; Rachel A Freedman; Harold Burstein; Julie Gralow; Antonio C Wolff; Gustav Magrinat; Myra Barginear; Hyman Muss Journal: J Am Geriatr Soc Date: 2018-08-26 Impact factor: 5.562
Authors: Michael T Halpern; Matthew P Urato; Lisa M Lines; Julia B Cohen; Neeraj K Arora; Erin E Kent Journal: J Geriatr Oncol Date: 2017-12-15 Impact factor: 3.599
Authors: Kah Poh Loh; Vivian Lam; Katey Webber; Simran Padam; Mina S Sedrak; Vivek Musinipally; Madison Grogan; Carolyn J Presley; Janice Grandi; Chandrika Sanapala; Daniel A Castillo; Grace DiGiovanni; Supriya G Mohile; Louise C Walter; Melisa L Wong Journal: J Natl Compr Canc Netw Date: 2021-04-15 Impact factor: 12.693
Authors: Chenkai Wu; Ya-Xi Li; Megan M Marron; Michelle C Odden; Anne B Newman; Jason L Sanders Journal: J Gerontol A Biol Sci Med Sci Date: 2020-09-25 Impact factor: 6.591