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Falls in the Community Dwelling Elderly with a History of Cancer

有癌症病史的社区老人跌倒

基本信息

批准号：
7997364
负责人：
Sandra Lee Spoelstra
金额：
$ 1.36万
依托单位：
MICHIGAN STATE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-08-16 至 2010-12-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7997364
关键词：
Age Behavioral Body Weight decreased Cancer Patient Cancer Survivor Cancer Survivorship Caring Cognition Colon Communities Comorbidity Data Analyses Diagnosis Diagnostic Neoplasm Staging Disease Elderly Equation Ethnic Origin Fall prevention Fracture Health Health Care Costs Healthcare Home environment Hospitalization Incontinence Injury Intervention Life Linear Models Literature Longitudinal Studies Lung Malignant Neoplasms Medicare/Medicaid Mental Depression Michigan Nursing Homes Patients Pharmaceutical Preparations Population Prophylactic treatment Prostate Quality of life Race Radiation Recording of previous events Research Proposals Risk Assessment cancer diagnosis cancer site cancer therapy chemotherapy community based service economic impact end of life experience fall risk falls frailty malignant breast neoplasm neoplasm registry older patient patient population programs psychologic psychosocial public health relevance sex social

项目摘要

DESCRIPTION (provided by applicant): Cancer survivors are living longer, but continue to encounter physical, psychosocial, and economic impacts of their cancer until the end of life. Of all types of injuries, falls pose the most serious threat to quality of life in the elderly, and consequently in elderly cancer survivors. There is a gap in the literature with few studies focusing on falls subsequent to cancer. The hypothesis in this proposal is that community dwelling elderly cancer survivors experience the influence of the disease or treatment of cancer, and have increased falls, fall sequelae, and use of healthcare. The plan in this proposal is: to conduct an analysis of data from the Michigan Home and Community Based Services program combined with information from the Cancer Registry, and Medicare and Medicaid claims. This study will explore, compare and contrast falls, fall sequelae, and healthcare use in those with and without a cancer diagnosis in community dwelling elderly patient population. Specific aims include: 1) After adjusting for age, sex, race/ethnicity, medications, comorbidities, ADLs, cognition, depression, incontinence, weight loss, and number of falls in the year prior to cancer diagnosis, to determine the extent to which: patients with a cancer diagnosis experience a greater number of falls, fractures, ER use, hospitalization, or nursing home placement, in the year following the cancer diagnosis compared to those patients with no diagnosis of cancer; and if there are differences in the number of falls among cancer patients in the year following diagnosis according to site of cancer (breast, colon, prostate, lung, or hematological), stage of cancer (I-IV.), or cancer treatment (chemotherapy and/or radiation); and 2) to examine if the effects of frailty (ADL, cognition, depression, incontinence, weight loss) on falls in the year after diagnosis are different with respect to site of cancer (breast, colon, prostate, lung, or hematological), stage of cancer, or cancer treatment (chemotherapy and/or radiation). Moreover, social factors will be described. The statistical approaches that accommodate the variables in this study are longitudinal Generalized Linear models and Generalized Estimating Equations. If falls, fall sequelae, or healthcare use in cancer survivors are different, then gerontological clinicians could focus on standardize fall risk assessment, and implement behavioral and psychological interventions to prevent falls. Accordingly, inclusion of fall prevention measures may be needed in Cancer Survivorship Care Planning mechanisms, to attempt to reduce the occurrence of falls in cancer survivors. Falls will become more important as the elderly cancer survivors population increases in size and health care costs continue to rise. PUBLIC HEALTH RELEVANCE: This research proposal is important to the health of elderly cancer survivors. If it is found that those who have a cancer diagnosis fall more often than those who do not have cancer, healthcare provides could target interventions to those who are most in need.

描述（由申请人提供）：癌症幸存者的寿命更长，但继续遇到身体，心理社会和经济的影响，他们的癌症，直到生命的尽头。在所有类型的伤害中，福尔斯对老年人的生活质量构成最严重的威胁，因此对老年癌症幸存者也是如此。文献中存在空白，很少有研究关注癌症后的福尔斯。该提案中的假设是，社区居住的老年癌症幸存者经历了癌症疾病或治疗的影响，并且增加了福尔斯、跌倒后遗症和医疗保健的使用。该提案中的计划是：对密歇根州家庭和社区服务计划的数据进行分析，结合癌症登记处的信息，以及医疗保险和医疗补助索赔。本研究将探讨、比较和对比社区居住老年患者人群中有和无癌症诊断的福尔斯、跌倒后遗症和医疗保健使用情况。具体目标包括：1）在调整了年龄、性别、种族/民族、药物、合并症、ADL、认知、抑郁、失禁、体重减轻和癌症诊断前一年的福尔斯次数后，确定以下情况的程度：诊断为癌症的患者经历更多的福尔斯、骨折、ER使用、住院或疗养院安置，在癌症诊断后的一年中，与未诊断出癌症的患者相比;以及根据癌症部位，癌症患者在诊断后一年内的福尔斯次数是否存在差异（乳腺癌、结肠癌、前列腺癌、肺癌或血液学），癌症分期（I-IV.），或癌症治疗（化疗和/或放疗）;和2）检查在诊断后一年内虚弱（ADL、认知、抑郁、失禁、体重减轻）对福尔斯的影响是否因癌症部位（乳腺、结肠、前列腺、肺或血液学）、癌症阶段或癌症治疗（化疗和/或放疗）而不同。此外，还将说明社会因素。本研究中适应变量的统计方法是纵向广义线性模型和广义估计方程。如果癌症幸存者的福尔斯、跌倒后遗症或医疗保健使用不同，那么老年医学临床医生可以专注于标准化跌倒风险评估，并实施行为和心理干预以预防福尔斯。因此，可能需要在癌症幸存者护理计划机制中纳入跌倒预防措施，以减少癌症幸存者福尔斯的发生。随着老年癌症幸存者人口规模的增加和医疗保健费用的持续上升，福尔斯将变得更加重要。公共卫生相关性：这项研究提案对老年癌症幸存者的健康很重要。如果发现那些患有癌症诊断的人比那些没有癌症的人更容易跌倒，医疗保健提供者可以针对那些最需要的人进行干预。