D K Ehlers, N Weaver, J Ma, S K Mama, L L Page, J Rowland, H Arem
{"title":"美国成年癌症幸存者的功能限制。","authors":"D K Ehlers, N Weaver, J Ma, S K Mama, L L Page, J Rowland, H Arem","doi":"10.1007/s11764-024-01638-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Using data from the National Health Interview Survey (NHIS), this study examined the odds of functional limitations across nine domains by cancer status (with vs. without cancer history) and age group (18-44, 45-64, 65 + years).</p><p><strong>Methods: </strong>Participants were 151,509 adults in the 2014-2018 NHIS. Functional limitations included self-reported difficulty conducting nine activities. Data were analyzed using age-stratified multivariate logistic regression (no limitation vs. limited in any way; minor limitation vs. major limitation) and are reported as covariate-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs). To gather insight on the influence of cancer, compared to aging without a history of cancer, on functional limitations, we also conducted exploratory regression analyses comparing all cancer by age groups to 18-44 year-olds without a cancer history.</p><p><strong>Results: </strong>Cancer survivors (n = 12,518) were more likely to report a limitation than adults without cancer (n = 138,991). Age-stratified ORs for 1 + limitation were 2.75 (95% CI 1.98, 3.81) among 18-44 year-olds, 2.42 (95% CI 2.00, 2.93) among 45-64 year-olds, and 1.59 (95% CI 1.39, 1.82) among 65 + year-olds. Cancer survivors were more likely to report major limitations across multiple domains, with age-stratified ORs ranging from 1.18 (65 + year-olds, stooping limitation) to 2.28 (18-44 year-old, sitting limitation). ORs from exploratory analyses were lowest among 45-64 year-old adults without a cancer history (2.69-4.42) and highest among older adult cancer survivors (3.42-14.73).</p><p><strong>Conclusions: </strong>Cancer was associated with limitations across age groups, with the highest age-stratified ORs observed among younger adults and for mobility and lower-extremity limitations. Stronger efforts to assess limitations as part of routine care and implement targeted interventions to address limitations are needed.</p><p><strong>Implications for cancer survivors: </strong>Functional limitations have been linked with poorer aging trajectories and lower quality of life in cancer and non-cancer populations. Routine screening to identify and discuss functional limitations with cancer patients may help reduce the burden of such limitations on survivors.</p>","PeriodicalId":15284,"journal":{"name":"Journal of Cancer Survivorship","volume":null,"pages":null},"PeriodicalIF":3.1000,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Functional limitations among adult cancer survivors in the United States.\",\"authors\":\"D K Ehlers, N Weaver, J Ma, S K Mama, L L Page, J Rowland, H Arem\",\"doi\":\"10.1007/s11764-024-01638-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Using data from the National Health Interview Survey (NHIS), this study examined the odds of functional limitations across nine domains by cancer status (with vs. without cancer history) and age group (18-44, 45-64, 65 + years).</p><p><strong>Methods: </strong>Participants were 151,509 adults in the 2014-2018 NHIS. Functional limitations included self-reported difficulty conducting nine activities. Data were analyzed using age-stratified multivariate logistic regression (no limitation vs. limited in any way; minor limitation vs. major limitation) and are reported as covariate-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs). To gather insight on the influence of cancer, compared to aging without a history of cancer, on functional limitations, we also conducted exploratory regression analyses comparing all cancer by age groups to 18-44 year-olds without a cancer history.</p><p><strong>Results: </strong>Cancer survivors (n = 12,518) were more likely to report a limitation than adults without cancer (n = 138,991). Age-stratified ORs for 1 + limitation were 2.75 (95% CI 1.98, 3.81) among 18-44 year-olds, 2.42 (95% CI 2.00, 2.93) among 45-64 year-olds, and 1.59 (95% CI 1.39, 1.82) among 65 + year-olds. Cancer survivors were more likely to report major limitations across multiple domains, with age-stratified ORs ranging from 1.18 (65 + year-olds, stooping limitation) to 2.28 (18-44 year-old, sitting limitation). ORs from exploratory analyses were lowest among 45-64 year-old adults without a cancer history (2.69-4.42) and highest among older adult cancer survivors (3.42-14.73).</p><p><strong>Conclusions: </strong>Cancer was associated with limitations across age groups, with the highest age-stratified ORs observed among younger adults and for mobility and lower-extremity limitations. Stronger efforts to assess limitations as part of routine care and implement targeted interventions to address limitations are needed.</p><p><strong>Implications for cancer survivors: </strong>Functional limitations have been linked with poorer aging trajectories and lower quality of life in cancer and non-cancer populations. 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引用次数: 0
摘要
目的：本研究利用全国健康访谈调查（NHIS）的数据，按照癌症状况（有癌症史与无癌症史）和年龄组（18-44 岁、45-64 岁、65 岁以上）对九个领域的功能限制几率进行了研究：参与者为 2014-2018 年 NHIS 中的 151,509 名成年人。功能限制包括自我报告进行九项活动的困难。数据采用年龄分层多变量逻辑回归（无限制 vs. 任何方式的限制；轻微限制 vs. 主要限制）进行分析，并以协变量调整后的几率比（ORs）和 95% 置信区间（95% CIs）进行报告。为了深入了解癌症与无癌症病史的老年人相比对功能限制的影响，我们还进行了探索性回归分析，将所有癌症患者按年龄组与无癌症病史的 18-44 岁人群进行了比较：癌症幸存者（12,518 人）比未患过癌症的成年人（138,991 人）更有可能报告功能受限。在 18-44 岁人群中，1 + 限制的年龄分层 OR 为 2.75 (95% CI 1.98, 3.81)，在 45-64 岁人群中为 2.42 (95% CI 2.00, 2.93)，在 65 岁以上人群中为 1.59 (95% CI 1.39, 1.82)。癌症幸存者更有可能报告在多个领域存在严重障碍，其年龄分层 OR 值从 1.18（65 岁以上人群，弯腰受限）到 2.28（18-44 岁人群，坐立受限）不等。探索性分析得出的OR值在45-64岁无癌症病史的成年人中最低（2.69-4.42），在老年癌症幸存者中最高（3.42-14.73）：结论：癌症与各年龄组的活动受限都有关系，年轻成年人的年龄分层OR值最高，活动受限和下肢活动受限的OR值也最高。作为常规护理的一部分，需要加强对功能受限的评估，并实施有针对性的干预措施来解决功能受限问题：在癌症和非癌症人群中，功能限制与较差的衰老轨迹和较低的生活质量有关。对癌症患者进行常规筛查以识别和讨论功能受限问题，可能有助于减轻此类受限问题给幸存者带来的负担。
Functional limitations among adult cancer survivors in the United States.
Purpose: Using data from the National Health Interview Survey (NHIS), this study examined the odds of functional limitations across nine domains by cancer status (with vs. without cancer history) and age group (18-44, 45-64, 65 + years).
Methods: Participants were 151,509 adults in the 2014-2018 NHIS. Functional limitations included self-reported difficulty conducting nine activities. Data were analyzed using age-stratified multivariate logistic regression (no limitation vs. limited in any way; minor limitation vs. major limitation) and are reported as covariate-adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs). To gather insight on the influence of cancer, compared to aging without a history of cancer, on functional limitations, we also conducted exploratory regression analyses comparing all cancer by age groups to 18-44 year-olds without a cancer history.
Results: Cancer survivors (n = 12,518) were more likely to report a limitation than adults without cancer (n = 138,991). Age-stratified ORs for 1 + limitation were 2.75 (95% CI 1.98, 3.81) among 18-44 year-olds, 2.42 (95% CI 2.00, 2.93) among 45-64 year-olds, and 1.59 (95% CI 1.39, 1.82) among 65 + year-olds. Cancer survivors were more likely to report major limitations across multiple domains, with age-stratified ORs ranging from 1.18 (65 + year-olds, stooping limitation) to 2.28 (18-44 year-old, sitting limitation). ORs from exploratory analyses were lowest among 45-64 year-old adults without a cancer history (2.69-4.42) and highest among older adult cancer survivors (3.42-14.73).
Conclusions: Cancer was associated with limitations across age groups, with the highest age-stratified ORs observed among younger adults and for mobility and lower-extremity limitations. Stronger efforts to assess limitations as part of routine care and implement targeted interventions to address limitations are needed.
Implications for cancer survivors: Functional limitations have been linked with poorer aging trajectories and lower quality of life in cancer and non-cancer populations. Routine screening to identify and discuss functional limitations with cancer patients may help reduce the burden of such limitations on survivors.
期刊介绍：
Cancer survivorship is a worldwide concern. The aim of this multidisciplinary journal is to provide a global forum for new knowledge related to cancer survivorship. The journal publishes peer-reviewed papers relevant to improving the understanding, prevention, and management of the multiple areas related to cancer survivorship that can affect quality of care, access to care, longevity, and quality of life. It is a forum for research on humans (both laboratory and clinical), clinical studies, systematic and meta-analytic literature reviews, policy studies, and in rare situations case studies as long as they provide a new observation that should be followed up on to improve outcomes related to cancer survivors. Published articles represent a broad range of fields including oncology, primary care, physical medicine and rehabilitation, many other medical and nursing specialties, nursing, health services research, physical and occupational therapy, public health, behavioral medicine, psychology, social work, evidence-based policy, health economics, biobehavioral mechanisms, and qualitative analyses. The journal focuses exclusively on adult cancer survivors, young adult cancer survivors, and childhood cancer survivors who are young adults. Submissions must target those diagnosed with and treated for cancer.
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