Changes in Physical and Cognitive Functioning among Cancer Survivors

描述(由申请人提供)：这项拟议的研究的目标是基于NIA资助的健康和退休研究的纵向数据，检查癌症诊断对老年癌症幸存者身体和认知功能的影响。公众使用十波(1992-2010年)的HRS数据将与受限的HRS癌症数据联系起来，以识别新诊断为癌症的受访者，并根据主要癌症类型形成队列。有关社会人口学、合并症和健康行为的数据将被用来评估癌症幸存者在随后的时间点上表现出的身体和认知功能的差异，并与没有癌症病史的人进行比较，以帮助区分癌症的影响和衰老的正常影响。这些数据将与HRS医疗保险索赔和汇总数据(2007年)联系起来，以确定疾病的程度和治疗方式(S)。将使用多水平建模和逻辑回归模型来检查随时间的变化以及预测因素和变化模式之间的关联。这项研究将检验一种假设，即癌症的诊断对身体和认知功能有显著的负面影响，而不是对衰老的正常影响。我们假设癌症诊断后身体和认知功能不良改变的风险受到各种与治疗相关的因素以及诊断前和/或诊断后的社会经济和健康因素的影响。从拟议的项目中获得的洞察力将提高我们对老年人癌症诊断后不利的身体和认知健康后果的理解，并将为旨在解决与年龄相关和与癌症相关的后果的干预措施提供信息，以改善长期癌症幸存者的生活质量。

DESCRIPTION (provided by applicant): The objective of the proposed research is to examine the impact of a cancer diagnosis on physical and cognitive functioning among older cancer survivors based on longitudinal data from the NIA-funded Health and Retirement Study. Public use HRS data from ten waves (1992-2010) will be linked to restricted HRS cancer data to identify respondents newly diagnosed with cancer and to form cohorts by major types of cancer. Data on sociodemographics, co-morbidities, and health behaviors, will be used to assess differences in physical and cognitive functioning exhibited at subsequent time points among cancer survivors and compared to persons with no history of cancer, to help separate the effects of cancer from the normal effects of aging. These data will be linked to the HRS Medicare Claims and Summary Data (2007) to identify extent of disease and treatment modality(s). Multilevel modeling and logistic regression models will be used to examine change over time and the association between predictors and patterns of change. This research will test the hypothesis that the diagnosis of cancer has a significant negative effect on physical and cognitive functioning separate from the normal effects of aging. We hypothesize that the risk of adverse changes in physical and cognitive functioning after a cancer diagnosis is influenced by various treatment-related factors as well as by socioeconomic and health factors present before and/or after diagnosis. Insight gained from the proposed project will improve our understanding of the adverse physical and cognitive health outcomes following a cancer diagnosis in older adults and will inform interventions targeted at addressing both age-related and cancer-related consequences to improve the quality of life for long-term cancer survivors.