{"title":"What are the determinants of functional decline in older adults with cancer? Results from the INCAPAC study","authors":"Yvanna Simon , Catherine Helmer , Fleur Delva , Isabelle Baldi , Gaëlle Coureau , Sandra Leguyader-Peyrou , Hélène Amieva , Simone Mathoulin-Pelissier , Karine Pérès , Angéline Galvin","doi":"10.1016/j.jgo.2025.102223","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Older adults with cancer are exposed to greater difficulties in carrying out their daily activities due to cancer itself, its treatment, or both. The aim of this study was to describe functional decline after cancer diagnosis and to investigate the determinants of this decline among older individuals with cancer.</div></div><div><h3>Materials and Methods</h3><div>Using the Gironde cancer registries, older subjects (≥65 years) with a diagnosis of cancer between 2005 and 2018 were identified in three prospective cohorts on aging. Functional decline was defined as an increase of 1 point for Activities of Daily Living (ADL), 2 points for Instrumental Activities of Daily Living (IADL), and 3 points for the overall score (ADL + IADL) between cancer pre- and post-diagnosis visits. Logistic regression models were used to identify determinants of functional decline among older subjects who underwent a post-diagnostic assessment. Additionally, multinomial logistic regression models were performed to account for individuals who had died prior to the post-diagnostic cancer visit.</div></div><div><h3>Results</h3><div>A total of 306 individuals followed-up after the cancer diagnosis were included (median age at cancer diagnosis: 83; 44 % female). Older age at cancer, low educational level, impaired initial functional status, and poor five-year cancer-related prognosis were significantly associated with functional decline across all three scores. Multinomial logistic regression analyses (<em>n</em> = 489) yielded similar results, but only cancer-related factors, specifically unfavorable vital prognosis, were associated with higher risk of death.</div></div><div><h3>Discussion</h3><div>Functional decline in older individuals with cancer is both multifactorial and multidimensional. Further studies are needed to disentangle the effects of cancer and aging.</div></div>","PeriodicalId":15943,"journal":{"name":"Journal of geriatric oncology","volume":"16 4","pages":"Article 102223"},"PeriodicalIF":3.0000,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of geriatric oncology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1879406825000396","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
What are the determinants of functional decline in older adults with cancer? Results from the INCAPAC study
Introduction
Older adults with cancer are exposed to greater difficulties in carrying out their daily activities due to cancer itself, its treatment, or both. The aim of this study was to describe functional decline after cancer diagnosis and to investigate the determinants of this decline among older individuals with cancer.
Materials and Methods
Using the Gironde cancer registries, older subjects (≥65 years) with a diagnosis of cancer between 2005 and 2018 were identified in three prospective cohorts on aging. Functional decline was defined as an increase of 1 point for Activities of Daily Living (ADL), 2 points for Instrumental Activities of Daily Living (IADL), and 3 points for the overall score (ADL + IADL) between cancer pre- and post-diagnosis visits. Logistic regression models were used to identify determinants of functional decline among older subjects who underwent a post-diagnostic assessment. Additionally, multinomial logistic regression models were performed to account for individuals who had died prior to the post-diagnostic cancer visit.
Results
A total of 306 individuals followed-up after the cancer diagnosis were included (median age at cancer diagnosis: 83; 44 % female). Older age at cancer, low educational level, impaired initial functional status, and poor five-year cancer-related prognosis were significantly associated with functional decline across all three scores. Multinomial logistic regression analyses (n = 489) yielded similar results, but only cancer-related factors, specifically unfavorable vital prognosis, were associated with higher risk of death.
Discussion
Functional decline in older individuals with cancer is both multifactorial and multidimensional. Further studies are needed to disentangle the effects of cancer and aging.
期刊介绍:
The Journal of Geriatric Oncology is an international, multidisciplinary journal which is focused on advancing research in the treatment and survivorship issues of older adults with cancer, as well as literature relevant to education and policy development in geriatric oncology.
The journal welcomes the submission of manuscripts in the following categories:
• Original research articles
• Review articles
• Clinical trials
• Education and training articles
• Short communications
• Perspectives
• Meeting reports
• Letters to the Editor.