PHYSICAL FUNCTIONING AND SELF-RATED HEALTH OF AGING CANCER SURVIVORS

描述（由申请人提供）：随着许多癌症诊断后的长期生存率提高，美国癌症幸存者的数量继续增长。为了更好地确定癌症幸存者的持续需求，需要更好地了解各种癌症结果。特别是身体功能和自我评估健康（SRH）已被证明与幸存者进一步残疾和死亡的风险增加有关，因此是癌症幸存者研究的一个重要研究重点。尽管先前的研究描述了癌症幸存者的身体功能和SRH结果，但研究设计的局限性，对诊断时或不久之后的评估的关注，以及缺乏长期的身体功能和SRH的诊断前后数据，阻碍了研究人员了解癌症诊断对身体功能和SRH的短期和长期影响的能力。我们需要了解癌症如何影响老年人的正常衰老轨迹，以确定预防损伤的目标，以及干预措施，以使患者康复，并随着时间的推移维持（如果不能改善）他们的功能和参与活动的能力。拟议的研究将使用由美国国家保险局资助的健康和退休研究的现有数据，以解决以下具体目标：通过癌症状态检查和比较老年人身体功能和SRH的轨迹；2. 确定长期影响癌症幸存者身体功能和SRH轨迹的人和环境因素；和3。探讨身体功能和SRH的轨迹是否因癌症部位而异（乳腺癌、前列腺癌、结直肠癌和肺癌的幸存者）。这项研究的结果将告知新的临床实践指南的需求和范围，以解决老年癌症幸存者的身体功能和康复服务需求；确定针对新诊断癌症患者的干预措施、计划或服务的需求和时机，以防止身体功能或自我评估健康的下降；并确定人和环境因素如何影响癌症幸存者的身体功能和性生殖健康。

DESCRIPTION (provided by applicant): With greater long-term survival after diagnosis for many cancers, the number of cancer survivors in the US continues to grow. A better understanding of a variety of cancer outcomes is needed to best identify the ongoing needs of cancer survivors. Physical functioning and self- rated health (SRH), in particular, have been shown to be associated with increased risk of further disability and mortality among survivors and therefore are an important focus of study in cancer survivorship research. Despite prior research that describes physical functioning and SRH outcomes among cancer survivors, limitations in study design, a focus on assessments at diagnosis or soon after, and lack of long-term pre/post-diagnosis data on physical functioning and SRH have stymied researchers' ability to understand the short- and long-term impact of a cancer diagnosis on physical functioning and SRH. An understanding of how cancer affects the normal aging trajectory of older adults is needed to identify targets of prevention for impairment as well as interventions to rehabilitate patients and maintain if not improve their functioning and ability to participate in activities over time. The proposed study will use existing data from the NIA-funded Health and Retirement Study to address the following specific aims: 1. Examine and compare trajectories of physical functioning and SRH among older adults by cancer status; 2. Identify person and environment factors that influence physical functioning and SRH trajectories among cancer survivors over time; and 3. Explore whether trajectories of physical functioning and SRH vary by cancer site (among survivors of breast, prostate, colorectal and lung cancer). Findings from this study will inform the need and scope for new clinical practice guidelines to address physical functioning and rehabilitation service needs among older cancer survivors over time; identify the need and timing of interventions, programs, or services targeted to newly diagnosed cancer patients that can prevent declines in physical functioning or self- rated health; and identify ways in which person and environment factors influence physical functioning and SRH among cancer survivors.