Grant R Williams1,2,3, Mustafa Al-Obaidi4, Chen Dai4, Christian Harmon4, Thomas W Buford5, Olumide Gbolahan6, Mackenzi Pergolotti7, Smita Bhatia4, Smith Giri4,6. 1. Institute for Cancer Outcomes & Survivorship, University of Alabama At Birmingham, Birmingham, AL, USA. grwilliams@uabmc.edu. 2. Division of Hematology and Oncology, Department of Medicine, University of Alabama At Birmingham, Birmingham, AL, USA. grwilliams@uabmc.edu. 3. O'Neal Comprehensive Cancer Center At UAB, University of Alabama At Birmingham, 1600 7th Avenue South, Lowder 500, Birmingham, AL, 35233, USA. grwilliams@uabmc.edu. 4. Institute for Cancer Outcomes & Survivorship, University of Alabama At Birmingham, Birmingham, AL, USA. 5. Center for Exercise Medicine, University of Alabama At Birmingham, Birmingham, AL, USA. 6. Division of Hematology and Oncology, Department of Medicine, University of Alabama At Birmingham, Birmingham, AL, USA. 7. ReVital Cancer Rehabilitation, Select Medical, Mechanicsburg, PA, USA.
Abstract
PURPOSE: Fatigue is a component of frailty and may undermine functional well-being and independent living. The prevalence of fatigue and its impact on functional limitations among older adults with cancer remains understudied. METHODS: Using participants enrolled in the Cancer and Aging Resilience Evaluation (CARE), a prospective registry of patients (≥ 60 years) with cancer, who underwent a geriatric assessment (GA) at the first visit with oncology, we examined the presence of fatigue based on self-report of moderate to severe fatigue on PROMIS global health 10-item instrument at the time of GA. We examined the association of fatigue with impairments in instrumental activities of daily living (IADL) and activities of daily living (ADL) adjusting for age, sex, race/ethnicity, education, cancer type and stage, pain, comorbidities, and time from cancer. RESULTS: We included 374 older adults with cancer with a median age of 70 years; 56% were male and 23% black. Diagnoses included colorectal (33%) and pancreatic cancers (25%), with most patients with advanced stage disease (71% stage III/IV). Overall, 210 (58%) patients reported significant fatigue. Patients reporting significant fatigue had an increased odds of IADL (adjusted odds ratio, aOR 1.9; 95% CI 1.1-3.2) or ADL impairment (aOR 3.6; 95% CI 1.4-9.3), as compared to those without, after adjusting for aforementioned confounders. CONCLUSIONS: Over half of older adults with cancer reported moderate to severe fatigue that was independently associated with functional status limitations. Further understanding of the multifaceted aspects of fatigue and development of interventions combating fatigue in this population is urgently needed.
PURPOSE:Fatigue is a component of frailty and may undermine functional well-being and independent living. The prevalence of fatigue and its impact on functional limitations among older adults with cancer remains understudied. METHODS: Using participants enrolled in the Cancer and Aging Resilience Evaluation (CARE), a prospective registry of patients (≥ 60 years) with cancer, who underwent a geriatric assessment (GA) at the first visit with oncology, we examined the presence of fatigue based on self-report of moderate to severe fatigue on PROMIS global health 10-item instrument at the time of GA. We examined the association of fatigue with impairments in instrumental activities of daily living (IADL) and activities of daily living (ADL) adjusting for age, sex, race/ethnicity, education, cancer type and stage, pain, comorbidities, and time from cancer. RESULTS: We included 374 older adults with cancer with a median age of 70 years; 56% were male and 23% black. Diagnoses included colorectal (33%) and pancreatic cancers (25%), with most patients with advanced stage disease (71% stage III/IV). Overall, 210 (58%) patients reported significant fatigue. Patients reporting significant fatigue had an increased odds of IADL (adjusted odds ratio, aOR 1.9; 95% CI 1.1-3.2) or ADL impairment (aOR 3.6; 95% CI 1.4-9.3), as compared to those without, after adjusting for aforementioned confounders. CONCLUSIONS: Over half of older adults with cancer reported moderate to severe fatigue that was independently associated with functional status limitations. Further understanding of the multifaceted aspects of fatigue and development of interventions combating fatigue in this population is urgently needed.
Authors: Grant R Williams; Maria Pisu; Gabrielle B Rocque; Courtney P Williams; Richard A Taylor; Elizabeth A Kvale; Edward E Partridge; Smita Bhatia; Kelly M Kenzik Journal: Cancer Date: 2018-12-03 Impact factor: 6.860
Authors: Carol E DeSantis; Kimberly D Miller; William Dale; Supriya G Mohile; Harvey J Cohen; Corinne R Leach; Ann Goding Sauer; Ahmedin Jemal; Rebecca L Siegel Journal: CA Cancer J Clin Date: 2019-08-07 Impact factor: 508.702
Authors: Trevor A Jolly; Allison M Deal; Kirsten A Nyrop; Grant R Williams; Mackenzi Pergolotti; William A Wood; Shani M Alston; Brittaney-Belle E Gordon; Samara A Dixon; Susan G Moore; W Chris Taylor; Michael Messino; Hyman B Muss Journal: Oncologist Date: 2015-03-12