Physiologic Frailty As a Sign of Accelerated Aging Among Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study
Physiologic Frailty As a Sign of Accelerated Aging Among Adult Survivors of Childhood Cancer: A Report From the St Jude Lifetime Cohort Study
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DOI：
10.1200/jco.2013.52.2268
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发表时间：
2013-12-20
影响因子：
45.3
通讯作者：
Hudson, Melissa M.
中科院分区：
文献类型：
--
作者：
Ness, Kirsten K.;Krull, Kevin R.;Hudson, Melissa M.
目的虚弱，一种在9.9%的65岁及以上的个体中报告的表型（9.6%的女性; 5.2%的男性），尚未在成年儿童癌症幸存者（CCS）中进行评估。我们估计患病率的脆弱性和检查协会的发病率和mortality.Methods参与者包括1,922 CCS至少10年从最初的癌症诊断（男性，50.3%，平均年龄，33.6 - 8.1岁）和比较人口的341名参与者没有癌症病史。虚弱和虚弱被定义为以下两种和三种情况：低肌肉质量，自我报告的疲惫，低能量消耗，缓慢的步行速度和虚弱。发病率定义为3至4级慢性病（不良事件通用术语标准4.0版）。Fisher精确检验用于比较虚弱状态和发病率的百分比。在162名CCS患者的第二次随访中，使用Poisson回归评估虚弱和新发发病率之间的相关性。结果女性和男性的虚弱前和虚弱患病率分别为31.5%和13.1%，12.9%和2.7%，患病率随年龄增长而增加。虚弱的CCS比非虚弱的幸存者更有可能患有慢性疾病（82.1%对73.8%）。在调整现有慢性疾病的模型中，基线虚弱与死亡风险（风险比，2.6; 95%CI，1.2至6.2）和慢性疾病发作（相对风险，2.2; 95%CI，1.2至4.2）。结论年轻成人CCS中虚弱的患病率与65岁及以上的成年人相似，表明加速老化。
Purpose Frailty, a phenotype reported among 9.9% of individuals 65 years old and older (9.6% of women; 5.2% of men), has not been assessed among adult childhood cancer survivors (CCS). We estimated the prevalence of frailty and examined associations with morbidity and mortality.Methods Participants included 1,922 CCS at least 10 years from original cancer diagnosis (men, 50.3%; mean age, 33.6 8.1 years) and a comparison population of 341 participants without cancer histories. Prefrailty and frailty were defined as two and three of the following conditions: low muscle mass, self-reported exhaustion, low energy expenditure, slow walking speed, and weakness. Morbidity was defined as grade 3 to 4 chronic conditions (Common Terminology Criteria for Adverse Events version 4.0). Fisher's exact tests were used to compare, by frailty status, percentages of those with morbidity. In a subset of 162 CCS who returned for a second visit, Poisson regression was used to evaluate associations between frailty and new onset morbidity. Cox proportional hazards regression was used to evaluate associations between frailty and death.Results The prevalence of prefrailty and frailty were 31.5% and 13.1% among women and 12.9% and 2.7% among men, respectively, with prevalence increasing with age. Frail CCS were more likely than nonfrail survivors to have a chronic condition (82.1% v 73.8%). In models adjusted for existing chronic conditions, baseline frailty was associated with risk of death (hazard ratio, 2.6; 95% CI, 1.2 to 6.2) and chronic condition onset (relative risk, 2.2; 95% CI, 1.2 to 4.2).Conclusion The prevalence of frailty among young adult CCS is similar to that among adults 65 years old and older, suggesting accelerated aging.