Older cancer survivors more likely to experience accelerated functional decline
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Older cancer survivors had a greater likelihood and faster rate of functional decline — including weak grip strength, slow gait speed and lower overall physical performance — than those without a cancer history, according to study results.
The findings, published in Journal of the American Geriatrics Society, suggest that cancer and/or its treatment may change the trajectory of aging, researchers noted.
“Observational and intervention studies are needed for prevention, mitigation and/or reversal of aging-related effects of cancer and its treatment,” researchers wrote. “Evidence has begun to emerge indicating that cancer survivors experience accelerated aging. [Our] study examined this phenomenon by evaluating trajectories of functional decline in older adults with a history of a cancer diagnosis relative to those without a history of cancer.”
Investigators pooled data on 1,728 men and women aged 22 to 100 years included in the Baltimore Longitudinal Study of Aging between 2006 and 2019 who underwent clinical evaluation of functional status. Of these, 359 reported a history of cancer. The most common cancer types included prostate (38.7%), breast (17%) and melanoma (15%).
Participants completed a mean three (range, 1-13) follow-up visits. Mean follow-up was 5 years.
Researchers used generalized estimating equations to identify longitudinal associations between self-reported history of cancer and functional decline measures. They analyzed trajectories of decline using time-to-event and Cox proportional hazard models.
According to study results, individuals with a history of cancer had 1.42 (95% CI, 1.11-1.81) higher odds of weak grip strength than those without a cancer history. Among those aged older than 65 years, individuals with a history of cancer had 1.61 (95% CI, 1.28-2.02) higher odds of slow gait speed and a 0.11 (95% CI, 0.19-0.03) lower Health, Aging and Body Composition physical performance battery score than those with no cancer history.
Moreover, compared with older adults with no history of cancer, those with a history of cancer reported a steeper decline in grip strength and gait speed (P < .01).
Limitations of the study included the fact that the Baltimore Longitudinal Study of Aging is not a study of cancer risk or survivorship; thus, no data were available on cancer stage, pathology or treatment. Researchers also noted the potential for survivor bias among participants with a history of prevalent disease due to the fact they had to survive their cancer for at least 10 years to be enrolled, and that because study participants were generally healthy and free of serious chronic diseases upon enrollment, the results may not be generalizable to the overall population.
“It is unknown whether the etiology of the accelerated aging observed in our study stems from the impact of the cancer and/or its treatment, from underlying behavioral, environmental and genetic risk factors for cancer, or from a combination of these factors,” researchers wrote. “However, this study reinforces the need to develop intervention studies to prevent or mitigate cancer- and cancer treatment-associated functional decline. Ultimately, these types of interventions could potentially include exercise therapy, nutrition, novel pharmacological therapeutics or supportive care strategies and may help reduce the adverse aging effects experienced by many cancer survivors.”
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