Cancer symptom burden in seniors correlates with functional impairment
Higher cancer symptom burden in elderly adults is associated with functional impairment, reports a recent study.
The study included 359 elderly cancer patients (median age 81 years; 54.0 percent male) in whom symptom burden was measured using the Clinical Symptom Inventory. Functional impairment was assessed according to instrumental activities of daily living (IADL), the Short Physical Performance Battery (SPPB) or the Medical Outcomes Survey.
Almost half of the participants had advanced malignancy. At baseline, 69 percent had had prior surgery, 41 percent had received radiation and 32 percent had undergone chemotherapy. The majority (70 percent) had noncancer comorbidities, such as high blood pressure (59 percent) and arthritis (58 percent), as well as physical activity limitations (77.81 percent).
The highest vs lowest quartile of symptom burden was associated with significantly elevated rates of IADL impairment (91 percent vs 51 percent), physical activity limitation (93 percent vs 65 percent) and falls (55 percent vs 21 percent; p<0.01 for all).
Moreover, there was a significantly higher proportion of patients with SPPB score ≤9 in the topmost vs bottom quartile of symptom burden (92 percent vs 69 percent; p<0.01).
Bivariate logistic regression analysis further confirmed the link between symptom burden and physical function impairments. For instance, patients who were independent with IADLs reported lower symptom scores than those who required assistance (12.89±13.41 vs 27.97±21.47; p<0.001).The same was true for physical activity (lower vs higher symptom burden: 12.58±13.11 vs 26.36±20.98; p<0.001) and falls (19.01±19.03 vs 29.89±20.95; p<0.001).