Association of intraindividual variability in simple reaction time with balance and falls in older cancer survivors: A secondary analysis

Introduction

Intraindividual reaction time variability (IIRV) is associated with physical function and falls in older cancer-free adults but has been minimally studied in aging cancer survivors. The aims of this study were (a) to assess the association of IIRV with physical function and falls in chemotherapy-treated cancer survivors, (b) to determine if this relationship varied between middle-aged and older cancer survivors, and (c) to determine if any associations are independent of reaction response central tendency (i.e., total reaction accuracy) and locomotor impairment.

Materials and Methods

Fifty cancer survivors (n = 28 with age ≥ 65 years, 88 % female) post chemotherapy treatment were included in this cross-sectional study. Simple IIRV was defined as the standard deviation of simple reaction time from stick drop paradigm. Physical function was measured by time to complete five sit-to-stand (5STS), number of sit-to-stand repetitions in thirty seconds (STS30), and unipedal stance time (UST). Self-reported recurrent and injurious falls in the past year were recorded as secondary outcomes. Bivariate analyses were conducted between IIRV measures and physical function variables in middle-aged and older aged cancer survivors. Multivariable models were used to examine the associations of simple IIRV with UST and falls outcomes. Included covariates were age, total reaction accuracy, a measure of central reaction tendency, and presence of a locomotor risk factor (obesity or neuropathy).

Results

In older cancer survivors, Spearman correlations demonstrated significant relationships of simple IIRV with UST and STS30, but not STS. In multivariable models, the interaction of age ≥ 65 years with increasing levels of simple IIRV was independently associated with worse UST (B -0.919, 95 % CI -1.68, −0.159, p = 0.02), increased recurrent falls (OR 1.29, 95 % CI,1.04 1.61, p = 0.02), and injurious falls (OR 1.30, 95 % CI,1.04 1.63, p = 0.02).

Discussion

Simple IIRV was independently associated with balance and falls outcomes in older chemotherapy-treated cancer survivors. The relationship of IIRV to balance and falls did not extend to middle-aged cancer survivors, suggesting that IIRV may be of greater importance for cognitive motor control in older cancer survivors.