Patricia M Bamonti1, Rachel E Weiskittle2, Aanand D Naik3, Jonathan F Bean4, Jennifer A Moye5. 1. Staff Psychologist, New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Brockton, MA; Instructor, Harvard Medical School, Boston, MA. 2. Advanced Research Fellow, New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Brockton, MA; Advanced Research Fellow, Harvard Medical School, Boston, MA. 3. Investigator, Houston Center for Innovations in Quality, Effectiveness, and Safety; Michael E. DeBakey VA Medical Center, Houston, TX; Professor, Department of Medicine, Baylor College of Medicine, Houston, TX. 4. Director, New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Brockton, MA; Professor, Harvard Medical School, Boston, MA; Staff, Spaulding Rehabilitation Hospital, Boston, MA. 5. Associate Director for Education and Evaluation, New England Geriatric Research Education and Clinical Center (GRECC), VA Boston Healthcare System, Brockton, MA; Professor, Harvard Medical School, Boston, MA.
Abstract
Background: Cancer survivors are at risk for declines in physical functioning (PF). The strongest predictor of PF is prior PF. Clinically significant depression predicts declines in PF; however, the extent to which depression symptoms moderate the association between self-reported and performance-based measures of PF over time is unknown. Objective/Purpose: To examine whether level of depression symptoms in cancer survivors moderates the association of repeated self- and performance-based measures of PF at 6 and 18 months after cancer diagnosis. Methods: Prospective, observational study with assessment at 6 (T1), 12 (T2), and 18 months after cancer diagnosis (T3). Setting and Patients: Community-dwelling US veterans with newly diagnosed head and neck, esophageal, gastric, or colorectal cancers. Measurements: Measures included demographics, cancer variables (type, stage, severity, and treatment), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), Short Physical Performance Battery (SPPB), and self-reported PF (Patient-Reported Outcomes Measurement Information System-29 [PROMIS-29]). Results: Using hierarchical regression models, after adjustment for covariates, depression symptoms at T2 moderated the relationship between performance-based PF, SPPB (β = -0.24, P = .001) but not self-reported PF, PROMIS (β = -0.14, P = .05). In moderation analyses, SPPB T1 was only related to SPPB T3 when the PHQ-9 score was less than 9. Limitations: Majority White, male participants, did not measure chronicity of depression. Conclusions: Depression symptoms moderate the relationship of performance-based PF from baseline to 18 months.
Background: Cancer survivors are at risk for declines in physical functioning (PF). The strongest predictor of PF is prior PF. Clinically significant depression predicts declines in PF; however, the extent to which depression symptoms moderate the association between self-reported and performance-based measures of PF over time is unknown. Objective/Purpose: To examine whether level of depression symptoms in cancer survivors moderates the association of repeated self- and performance-based measures of PF at 6 and 18 months after cancer diagnosis. Methods: Prospective, observational study with assessment at 6 (T1), 12 (T2), and 18 months after cancer diagnosis (T3). Setting and Patients: Community-dwelling US veterans with newly diagnosed head and neck, esophageal, gastric, or colorectal cancers. Measurements: Measures included demographics, cancer variables (type, stage, severity, and treatment), depression symptoms (Patient Health Questionnaire-9 [PHQ-9]), Short Physical Performance Battery (SPPB), and self-reported PF (Patient-Reported Outcomes Measurement Information System-29 [PROMIS-29]). Results: Using hierarchical regression models, after adjustment for covariates, depression symptoms at T2 moderated the relationship between performance-based PF, SPPB (β = -0.24, P = .001) but not self-reported PF, PROMIS (β = -0.14, P = .05). In moderation analyses, SPPB T1 was only related to SPPB T3 when the PHQ-9 score was less than 9. Limitations: Majority White, male participants, did not measure chronicity of depression. Conclusions: Depression symptoms moderate the relationship of performance-based PF from baseline to 18 months.
Entities:
Keywords:
cancer survivors; depression; physical functioning
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