Jessica L Krok-Schoen1, Michael L Pennell2, Nazmus Saquib3, Michelle Naughton4, Xiaochen Zhang5, Aladdin H Shadyab6, Candyce H Kroenke7, Jennifer W Bea8, Lindsay L Peterson9, Tracy Crane10, Jean Wactawski-Wende11, Electra D Paskett12. 1. Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, 453 W. 10(th) Ave., 306 Atwell Hall, Columbus, OH 43210, USA. Electronic address: jessica.krok@osumc.edu. 2. Division of Biostatistics, College of Public Health, The Ohio State University, 246 Cunz Hall, 1841 Neil Ave., Columbus, OH 43210, USA. Electronic address: pennell.28@osu.edu. 3. College of Medicine, Sulaiman Alrajhi University, PO Box 777, Bukariyah, Qassim 51941, Saudi Arabia. Electronic address: a.saquib@sr.edu.sa. 4. Division of Cancer Prevention and Control, Department of Medicine, College of Medicine, The Ohio State University, 1590 N. High St., Columbus, OH 43210, USA. Electronic address: michelle.naughton@osumc.edu. 5. Division of Population Sciences, The Ohio State University Comprehensive Cancer Center, 1590 N. High St., Columbus, OH 43210, USA. Electronic address: xiaochen.zhang2@osumc.edu. 6. Herbert Wertheim School of Public Health and Human Longevity Science, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 92093, USA. Electronic address: ahshadya@health.ucsd.edu. 7. Kaiser Permanente Northern California Division of Research, 2000 Broadway, Oakland, CA, 94612, USA. Electronic address: candyce.h.kroenke@kp.org. 8. Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1515 N. Campbell Ave, Tucson, AZ 85724, USA. Electronic address: jbea@uacc.arizona.edu. 9. Division of Oncology, Department of Medicine, Washington University School of Medicine, 660 S. Euclid Ave., St. Louis, MO 63110, USA. Electronic address: llpeterson@wustl.edu. 10. Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Ave, Miami, FL 33136, USA. Electronic address: tecrane@miami.edu. 11. Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 410 Kimball Tower, Buffalo, NY 14214, USA. Electronic address: jww@buffalo.edu. 12. Division of Cancer Prevention and Control, Department of Medicine, College of Medicine, The Ohio State University, 1590 N. High St., Columbus, OH 43210, USA. Electronic address: electra.paskett@osumc.edu.
Abstract
INTRODUCTION: Physical activity can attenuate cancer-related declines in physical functioning, improve emotional well-being, and prolong survival among older (≥65 years) breast cancer survivors. However, factors associated with physical activity among older breast cancer survivors are not well-understood. MATERIALS AND METHODS: Participants were enrolled in the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study. Descriptive statistics, multiple linear regression, and relative risk [RR] regression were used to assess the association of demographic, clinical, physical and psychosocial variables with the total duration of and participation in physical activity among postmenopausal breast cancer survivors. Age-specific correlates (65-74 years vs. 75-84 years vs. ≥85 years) of physical activity were also examined. RESULTS: The majority of participants (n = 3710, mean age = 78.8 ± 5.9) were white (90.7%) and had in situ/localized breast cancer (78.9%). Women who had higher education (RR = 1.47 for graduate/professional school versus high school or less, 95% CI: 1.32, 1.63), higher self-rated health (RR = 1.04 for 10 point increase, 95% CI:1.02, 1.07), higher physical functioning (RR = 1.03 for 5 point increase, 95% CI: 1.02, 1.04), and higher social support (RR = 1.41 for social support all of the time versus none of the time, 95% CI: 1.01, 1.96), were more likely to engage in any physical activity. Similar results were observed for duration of physical activity. Among women aged <75, radiation therapy, but not chemotherapy, was associated with longer duration of total physical activity (adjusted difference = 19.7 min/week, 95% CI: 6.1, 33.3), but was not associated with duration among older women. The association between pain and duration of moderate/strenuous activity also differed with age: among women aged <75, those with moderate pain averaged fewer minutes of moderate/strenuous physical activity than those with no pain (adjusted difference:-14.4 min/week, 95% CI:-28.5, -0.1). However, among women aged ≥85, those with moderate pain averaged more minutes of moderate/strenuous physical activity per week than those with no pain (adjusted difference:16.6 min/week; 95% CI:2.9, 30.3). DISCUSSION: Multiple factors were associated with physical activity among older breast cancer survivors in the WHI. Future physical activity interventions should focus on age-related (e.g., comorbidities) and treatment-related factors (e.g., radiation) as well as certain subgroups, such as women with higher symptom burden.
INTRODUCTION: Physical activity can attenuate cancer-related declines in physical functioning, improve emotional well-being, and prolong survival among older (≥65 years) breast cancer survivors. However, factors associated with physical activity among older breast cancer survivors are not well-understood. MATERIALS AND METHODS: Participants were enrolled in the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study. Descriptive statistics, multiple linear regression, and relative risk [RR] regression were used to assess the association of demographic, clinical, physical and psychosocial variables with the total duration of and participation in physical activity among postmenopausal breast cancer survivors. Age-specific correlates (65-74 years vs. 75-84 years vs. ≥85 years) of physical activity were also examined. RESULTS: The majority of participants (n = 3710, mean age = 78.8 ± 5.9) were white (90.7%) and had in situ/localized breast cancer (78.9%). Women who had higher education (RR = 1.47 for graduate/professional school versus high school or less, 95% CI: 1.32, 1.63), higher self-rated health (RR = 1.04 for 10 point increase, 95% CI:1.02, 1.07), higher physical functioning (RR = 1.03 for 5 point increase, 95% CI: 1.02, 1.04), and higher social support (RR = 1.41 for social support all of the time versus none of the time, 95% CI: 1.01, 1.96), were more likely to engage in any physical activity. Similar results were observed for duration of physical activity. Among women aged <75, radiation therapy, but not chemotherapy, was associated with longer duration of total physical activity (adjusted difference = 19.7 min/week, 95% CI: 6.1, 33.3), but was not associated with duration among older women. The association between pain and duration of moderate/strenuous activity also differed with age: among women aged <75, those with moderate pain averaged fewer minutes of moderate/strenuous physical activity than those with no pain (adjusted difference:-14.4 min/week, 95% CI:-28.5, -0.1). However, among women aged ≥85, those with moderate pain averaged more minutes of moderate/strenuous physical activity per week than those with no pain (adjusted difference:16.6 min/week; 95% CI:2.9, 30.3). DISCUSSION: Multiple factors were associated with physical activity among older breast cancer survivors in the WHI. Future physical activity interventions should focus on age-related (e.g., comorbidities) and treatment-related factors (e.g., radiation) as well as certain subgroups, such as women with higher symptom burden.
Authors: Siobhan M Phillips; Kevin W Dodd; Jeremy Steeves; James McClain; Catherine M Alfano; Edward McAuley Journal: Gynecol Oncol Date: 2015-05-28 Impact factor: 5.482
Authors: Stephen J Mooney; Spruha Joshi; Magdalena Cerdá; James W Quinn; John R Beard; Gary J Kennedy; Ebele O Benjamin; Danielle C Ompad; Andrew G Rundle Journal: Am J Prev Med Date: 2015-06-16 Impact factor: 5.043
Authors: Amy M Dennett; Casey L Peiris; Nora Shields; Luke A Prendergast; Nicholas F Taylor Journal: J Physiother Date: 2016-03-17 Impact factor: 7.000
Authors: N K Aaronson; S Ahmedzai; B Bergman; M Bullinger; A Cull; N J Duez; A Filiberti; H Flechtner; S B Fleishman; J C de Haes Journal: J Natl Cancer Inst Date: 1993-03-03 Impact factor: 13.506