Comparison of changes in physical functioning of elderly patients with new diagnoses of cancer

Charles W. Given, Barbara Given, Faouzi Azzouz, Manfred Stommel, Sharon Kozachik

Research output: Contribution to journalReview articlepeer-review

Abstract

BACKGROUND. Controversy surrounds the impact of site of cancer and treatments on functioning of elderly cancer patients. OBJECTIVES. This research determines (1) whether age, gender, comorbid conditions, site and stage of cancer, and treatments are related to losses in physical functioning at 4 observations during the year after diagnosis; (2) whether symptoms are a mediating variable between treatment and function; and (3) which indicators account for true change in functioning in the year after diagnosis. METHODS. An inception cohort of 907 patients aged ≥65 years and newly diagnosed with breast, colon, lung, or prostate cancer were accrued from 24 community oncology programs. Stage and treatment data were obtained from medical records. Physical functioning was measured with the SF-36 subscale. Interviews were conducted at 6 to 8, 12 to 16, 26 to 30, and 52 weeks after diagnosis. RESULTS. Men scored 10 points higher on physical function than women at all observation points. Patients with ≥3 comorbid conditions scored lower in functioning. Interactions between site of cancer and treatment modalities were observed. Pain, fatigue, and numbers of symptoms were independent predictors of loss of function. Surgery, female gender, and number of symptoms predicted reliable change in function. CONCLUSIONS. Elderly patients with cancer report levels of function similar to other chronic conditions. Scores on physical function varied by site of cancer; the pattern of change was similar among sites. Age, comorbidity, treatment modalities, and symptom reports each had an independent effect on loss of functioning. Untreated breast cancer patients had lower functioning, suggesting a possible treatment bias.

Original languageEnglish (US)
Pages (from-to)482-493
Number of pages12
JournalMedical care
Volume38
Issue number5
DOIs
StatePublished - May 2000
Externally publishedYes

Keywords

  • Cancer
  • Comorbid conditions
  • Elderly
  • Physical function
  • Symptoms

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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