Physical Activity in Older Cancer Survivors: What Role Do Multimorbidity and Perceived Disability Play?
Physical Activity in Older Cancer Survivors: What Role Do Multimorbidity and Perceived Disability Play?
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DOI：
10.1123/japa.2019-0086
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发表时间：
2020-04-01
影响因子：
1.5
通讯作者：
Schmitz, Kathryn H.
中科院分区：
文献类型：
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作者：
Bluethmann, Shirley M.;Foo, Wayne;Schmitz, Kathryn H.
目的：(a) 描述癌症幸存者的多种发病率和体力活动 (PA) 的关系，(b) 探讨中年和老年幸存者的感知残疾和体力活动 (PA)。方法：作者分析了癌症幸存者 (N = 566) 的数据，这些数据是通过宾夕法尼亚州癌症登记处确定的，他们对行为风险因素监测系统衍生的问卷进行了答复。他们创建了年龄组（例如，45-54 岁、55-64 岁、65-74 岁和 75 岁及以上），并计算了八种常见合并症（例如，慢性阻塞性肺病、心脏病）的综合评分，以评估多重发病率。 Logistic 回归用于估计人口统计学和行为/临床风险因素（例如，多发病、感知残疾、体重指数）与 PA 的关联。结果：大多数受访者为女性 (62%)，年龄较大（平均年龄 = 68 岁），代表不同的癌症部位，包括乳腺癌 (n = 132)、结直肠癌 (n = 102)、妇科 (n = 106)、前列腺 (n = 111) 和肺癌 (n = 80)。 PA 参与情况参差不齐； 44% 的幸存者报告实现了 >150 分钟的有氧 PA，但一半的肺部幸存者和 37% 的妇科幸存者报告没有 PA（0 分钟/周）。较高的多重发病率（比值比 = 0.82，置信区间 [0.69, 0.98]，p < .05）、肥胖（比值比 = 0.51，置信区间 [0.30, 0.86]，p < .05）和感知残疾（比值比 = 0.49，置信区间 [0.32, 0.77]，p < .001）呈负值与 PA 参与相关。所有幸存者的力量训练均未达到最佳状态。结论：大多数老年幸存者都经历过合并症，这与 PA 较少有关。自认为残疾或肥胖的幸存者参与 PA 的可能性是其他人的一半。这表明在设计 PA 干预措施以满足现实世界的需求时越来越需要解决身体和心理的限制。满足老年幸存者对多种疾病、肥胖和感知残疾的独特需求的运动干预措施可能会增加 PA 的机会。
Purpose: (a) To describe the relationship of multimorbidity and physical activity (PA) in cancer survivors and (b) to explore perceived disability and PA in middle-aged and older survivors. Methods: The authors analyzed the data from cancer survivors (N= 566), identified using the Pennsylvania Cancer Registry, who responded to a Behavioral Risk Factor Surveillance System-derived questionnaire. They created age groups (e.g., 45-54 years, 55-64 years, 65-74 years, and 75 years and older) and calculated a composite score of eight common comorbidities (e.g., chronic obstructive pulmonary disease, heart disease) to assess multimorbidity. Logistic regression was used to estimate the association of demographic and behaviora/clinical risk factors (e.g., multimorbidity, perceived disability, body mass index) with PA. Results: Most respondents were females (62%), older (mean age = 68 years) and represented diverse cancer sites, including breast (n = 132), colorectal (n= 102), gynecologic (n=106), prostate (n = 111), and lung (n = 80). PA participation was mixed; 44% of survivors reported achieving >150 min of aerobic PA, but half of lung and 37% of gynecologic survivors reported no PA (0 min/week). Higher multimorbidity (odds ratio = 0.82, confidence interval [0.69, 0.98], p < .05), obesity (odds ratio = 0.51, confidence interval [0.30, 0.86], p < .05), and perceived disability (odds ratio = 0.49, confidence interval [0.32, 0.77], p < .001) were negatively associated with PA participation. Strength training was suboptimal across all survivors. Conclusion: Most older survivors experienced comorbid conditions, and this was associated with less PA. Survivors who perceived themselves as disabled or who were obese were half as likely as others to participate in PA. This suggests an increasing need to address both physical and psychological limitations in designing PA interventions for real-world needs. Exercise interventions that address the unique needs of older survivors for multimorbidity, obesity, and perceived disability may strengthen opportunities for PA.