Physical Performance and Subsequent Disability and Survival in Older Adults with Malignancy: Results from the Health, Aging and Body Composition Study

Authors

  • Heidi D. Klepin MD, MS,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • Ann M. Geiger PhD,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • Janet A. Tooze PhD,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • Anne B. Newman MD, MPH,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • Lisa H. Colbert PhD, MPH,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • Douglas C. Bauer MD,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • Suzanne Satterfield MD, DrPH,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • Juliessa Pavon MD,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • Stephen B. Kritchevsky PhD,

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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  • for the Health, Aging and Body Composition Study

    1. From the *Comprehensive Cancer Center, Division of Public Health Sciences, and Departments of Epidemiology and §Medicine, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Kinesiology, University of Wisconsin, Madison, Wisconsin; #Department of Medicine, University of California, San Francisco, California; **Department of Preventative Medicine, University of Tennessee, Memphis, Tennessee; and ††Department of Internal Medicine, Duke University, Durham, North Carolina ‡‡Sticht Center on Aging, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
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Address correspondence to Heidi D. Klepin, Comprehensive Cancer Center of Wake Forest University, Medical Center Boulevard, Winston-Salem, NC 27157. E-mail: hklepin@wfubmc.edu

Abstract

OBJECTIVES: To evaluate objective physical performance measures as predictors of survival and subsequent disability in older patients with cancer.

DESIGN: Longitudinal cohort study.

SETTING: Health, Aging and Body Composition (Health ABC) Study.

PARTICIPANTS: Four hundred twenty-nine individuals diagnosed with cancer during the first 6 years of follow-up of the Health ABC Study.

MEASUREMENTS: The associations between precancer measures of physical performance (20-m usual gait speed, 400-m long-distance corridor walk (LDCW), and grip strength) and overall survival and a short-term outcome of 2-year progression to disability or death were evaluated. Cox proportional hazards and logistic regression models, stratified for metastatic disease, respectively, were used for outcomes.

RESULTS: Mean age was 77.2, 36.1% were women, and 45.7% were black. Faster 20-m usual walking speed was associated with a lower risk of death in the metastatic group (hazard ratio=0.89, 95% confidence interval (CI)=0.79–0.99) and lower 2-year progression to disability or death in the nonmetastatic group (odds ratio (OR)=0.77, 95% CI=0.64–0.94). Ability to complete the 400-m LDCW was associated with lower 2-year progression to disability or death in the nonmetastatic group (OR=0.24, 95% CI=0.10–0.62). There were no associations between grip strength and disability or death.

CONCLUSION: Lower extremity physical performance tests (usual gait speed and 400-m LDCW) were associated with survival and 2-year progression to disability or death. Objective physical performance measures may help inform pretreatment evaluations in older adults with cancer.

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