Srihitha Padamatinti, Mackenzie E Fowler, Coryn Stephenson, Chen Dai, Smith Giri, Darryl Outlaw, Robert Hollis, Grant R Williams
{"title":"有限的健康素养与老年癌症患者的虚弱程度、与健康相关的生活质量和医疗保健使用率之间的关系：癌症与老龄化复原力评估登记》（The Cancer and Aging Resilience Evaluation Registry）。","authors":"Srihitha Padamatinti, Mackenzie E Fowler, Coryn Stephenson, Chen Dai, Smith Giri, Darryl Outlaw, Robert Hollis, Grant R Williams","doi":"10.1200/OP.24.00184","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Limited health literacy-ability to obtain, process, and understand health information-can hinder communication, access to medical treatment, and identification and management of comorbidities. Older adults have high rates of poor health literacy, but its role in aging-related outcomes among older adults with cancer is understudied.</p><p><strong>Methods: </strong>We included 876 older adults age 60 years and older with cancer from the Cancer and Aging Resilience Evaluation Registry completing self-reported geriatric assessment, including health literacy, at first visit to medical oncology. The exposure was limited health literacy. Outcomes were frailty, physical/mental health-related quality of life (HRQOL), and health care utilization. We used modified Poisson regression to examine the association of exposure on outcomes adjusting for age, race-ethnicity, sex, and cancer type/stage.</p><p><strong>Results: </strong>Median age at enrollment was 68; 57.8% were male; 20.2% were non-Hispanic Black. The most prevalent cancers were advanced-stage (46.8% stage IV) colorectal (26.9%) and pancreatic (19.0%). Those with limited health literacy were older (70 <i>v</i> 68 years; <i>P</i> < .001), male (63.0% <i>v</i> 55.1%; <i>P =</i> .026), non-Hispanic Black (28.8% <i>v</i> 16.1%; <i>P</i> < .001), ≤high school educated (62.3% <i>v</i> 28.1%; <i>P</i> < .001), and retired/disabled (86.3% <i>v</i> 71.2%; <i>P</i> < .001). In multivariable analysis, limited health literacy was associated with higher prevalence of frailty (prevalence ratio [PR], 2.64 [95% CI, 2.15 to 3.26]), impaired physical (PR, 1.90 [95% CI, 1.59 to 2.27]) and mental (PR, 2.08 [95% CI, 1.76 to 2.47]) HRQOL, and hospitalization in the last year (PR, 1.28 [95% CI, 1.10 to 1.48]) versus adequate health literacy.</p><p><strong>Conclusion: </strong>Older adults with cancer and limited health literacy had higher adjusted prevalence of frailty, impaired physical and mental HRQOL, and recent hospitalization. Interventions to address limited health literacy should be explored in this vulnerable and growing cancer population.</p>","PeriodicalId":14612,"journal":{"name":"JCO oncology practice","volume":" ","pages":"OP2400184"},"PeriodicalIF":4.7000,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Association of Limited Health Literacy With Frailty, Health-Related Quality of Life, and Health Care Utilization Among Older Adults With Cancer: The Cancer and Aging Resilience Evaluation Registry.\",\"authors\":\"Srihitha Padamatinti, Mackenzie E Fowler, Coryn Stephenson, Chen Dai, Smith Giri, Darryl Outlaw, Robert Hollis, Grant R Williams\",\"doi\":\"10.1200/OP.24.00184\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>Limited health literacy-ability to obtain, process, and understand health information-can hinder communication, access to medical treatment, and identification and management of comorbidities. Older adults have high rates of poor health literacy, but its role in aging-related outcomes among older adults with cancer is understudied.</p><p><strong>Methods: </strong>We included 876 older adults age 60 years and older with cancer from the Cancer and Aging Resilience Evaluation Registry completing self-reported geriatric assessment, including health literacy, at first visit to medical oncology. The exposure was limited health literacy. Outcomes were frailty, physical/mental health-related quality of life (HRQOL), and health care utilization. We used modified Poisson regression to examine the association of exposure on outcomes adjusting for age, race-ethnicity, sex, and cancer type/stage.</p><p><strong>Results: </strong>Median age at enrollment was 68; 57.8% were male; 20.2% were non-Hispanic Black. The most prevalent cancers were advanced-stage (46.8% stage IV) colorectal (26.9%) and pancreatic (19.0%). Those with limited health literacy were older (70 <i>v</i> 68 years; <i>P</i> < .001), male (63.0% <i>v</i> 55.1%; <i>P =</i> .026), non-Hispanic Black (28.8% <i>v</i> 16.1%; <i>P</i> < .001), ≤high school educated (62.3% <i>v</i> 28.1%; <i>P</i> < .001), and retired/disabled (86.3% <i>v</i> 71.2%; <i>P</i> < .001). In multivariable analysis, limited health literacy was associated with higher prevalence of frailty (prevalence ratio [PR], 2.64 [95% CI, 2.15 to 3.26]), impaired physical (PR, 1.90 [95% CI, 1.59 to 2.27]) and mental (PR, 2.08 [95% CI, 1.76 to 2.47]) HRQOL, and hospitalization in the last year (PR, 1.28 [95% CI, 1.10 to 1.48]) versus adequate health literacy.</p><p><strong>Conclusion: </strong>Older adults with cancer and limited health literacy had higher adjusted prevalence of frailty, impaired physical and mental HRQOL, and recent hospitalization. Interventions to address limited health literacy should be explored in this vulnerable and growing cancer population.</p>\",\"PeriodicalId\":14612,\"journal\":{\"name\":\"JCO oncology practice\",\"volume\":\" \",\"pages\":\"OP2400184\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-11-08\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JCO oncology practice\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1200/OP.24.00184\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JCO oncology practice","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1200/OP.24.00184","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ONCOLOGY","Score":null,"Total":0}
Association of Limited Health Literacy With Frailty, Health-Related Quality of Life, and Health Care Utilization Among Older Adults With Cancer: The Cancer and Aging Resilience Evaluation Registry.
Purpose: Limited health literacy-ability to obtain, process, and understand health information-can hinder communication, access to medical treatment, and identification and management of comorbidities. Older adults have high rates of poor health literacy, but its role in aging-related outcomes among older adults with cancer is understudied.
Methods: We included 876 older adults age 60 years and older with cancer from the Cancer and Aging Resilience Evaluation Registry completing self-reported geriatric assessment, including health literacy, at first visit to medical oncology. The exposure was limited health literacy. Outcomes were frailty, physical/mental health-related quality of life (HRQOL), and health care utilization. We used modified Poisson regression to examine the association of exposure on outcomes adjusting for age, race-ethnicity, sex, and cancer type/stage.
Results: Median age at enrollment was 68; 57.8% were male; 20.2% were non-Hispanic Black. The most prevalent cancers were advanced-stage (46.8% stage IV) colorectal (26.9%) and pancreatic (19.0%). Those with limited health literacy were older (70 v 68 years; P < .001), male (63.0% v 55.1%; P = .026), non-Hispanic Black (28.8% v 16.1%; P < .001), ≤high school educated (62.3% v 28.1%; P < .001), and retired/disabled (86.3% v 71.2%; P < .001). In multivariable analysis, limited health literacy was associated with higher prevalence of frailty (prevalence ratio [PR], 2.64 [95% CI, 2.15 to 3.26]), impaired physical (PR, 1.90 [95% CI, 1.59 to 2.27]) and mental (PR, 2.08 [95% CI, 1.76 to 2.47]) HRQOL, and hospitalization in the last year (PR, 1.28 [95% CI, 1.10 to 1.48]) versus adequate health literacy.
Conclusion: Older adults with cancer and limited health literacy had higher adjusted prevalence of frailty, impaired physical and mental HRQOL, and recent hospitalization. Interventions to address limited health literacy should be explored in this vulnerable and growing cancer population.
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