Physical and Functional Limitations in US Older Cancer Survivors

Objective: The ability to independently perform daily activities is a crucial component of quality of life among older cancer survivors. However, many cancer survivors face difficulties performing their daily activities for living an independent life. The purpose of this study was to evaluate whether physical and functional status significantly decreased in cancer survivors compared to people without cancer. Methods: The Medicare Current Beneficiary Survey (MCBS) is a nationally representative longitudinal study for the entire aged Medicare beneficiaries. Data from 2006 to 2010 were used for analysis of this study. Design-based descriptive analysis and logistic models with adjusted survey weights were performed. To ensure comparability between cancer and non-cancer older adults, propensity score weighting was developed using logistic regressions. Results: The final sample consisted of 11,533 participants. Cancer survivors had more limitations compared to non-cancer individuals: physical limitations (23.3% vs. 19.7%, p=0.006), activity daily living limitations (ADL) (7.7% vs. 5.8%, p=0.02), and instrumental activity of daily living limitations (IADL) (13.5% vs. 11.0%, p=0.02. The odds ratio (OR) for cancer survivors compared to non-cancer individuals was 1.62 (95% CI: 1.28-2.06) for physical limitations, 1.08 (95% CI: 0.72-1.62) for ADL, and 1.30 (95% CI: 0.97-1.73) for IADL. There was a one year lag in functional limitations resulting in one year loss of physical capabilities among cancer survivors. However, these differences between cancer and non-cancer participants decreased over the follow-up year (p=0.01). Conclusion: Cancer survivors have higher prevalence of physical and functional limitations compared to noncancer individuals. Such disparities in functional limitations impact the independent functioning of these survivors. Healthcare professionals need to recognize potential for debilitating functional abilities among cancer survivors and address their needs. Our findings extend our understanding of the burden of physical and functional limitations in cancer survivors and call for action from health care providers.