Physical Mobility and Balance Performance Differs in Older Cancer Survivors With Impaired Executive Function

Background and Purpose: Executive function (EF) is associated with falls and impaired gait in older adults. Performance on a measure of EF, the Trail Making Test Part B (TMT-B), may be able to differentiate between physical mobility and balance in older cancer survivors. The purpose of this study was to describe the demographic, disease-associated, and mobility differences in 2 groups of older cancer survivors based on the ability to complete TMT-B. Methods: Physical mobility and cognition was assessed in 50 older (aged 65+ years) cancer survivors. Group assignment was by TMT-B completion status (completers/noncompleters). Between-groups comparisons were performed on measures of physical mobility, balance, gait, and self-efficacy using nonparametric statistics. Results: Sixteen (32%) older cancer survivors were unable to complete TMT-B. Significant differences were found (P < .05) on all Timed Up and Go (TUG) measures in noncompleters versus completers: TUG (12.10 seconds vs 9.28 seconds), TUG-manual (12.81 seconds vs 10.88 seconds), TUG-cognitive (14.35 seconds vs 10.98 seconds). Noncompleters had significantly worse (P < .05) scores on the Short Physical Performance Battery, Fullerton Advanced Balance Scale, 30-second timed chair rise, balance confidence, falls self-efficacy, and all gait speed (usual, fast, dual-task) measures. Discussion: Older cancer survivors unable to complete TMT-B had worse performance in mobility, balance, strength, and dual-task activities that involve the increased demand of cognitive function. Executive function should be screened as a part of the falls risk management in older cancer survivors. Conclusion: Physical mobility, balance, and function are significantly more impaired in older cancers survivors who are unable to complete the TMT-B cognitive measure.