Function in Elderly Cancer Survivors Depends on Comorbidities

Abstract

Background. Factors associated with functional status in elderly cancer survivors, in particular, comorbidity, have been inadequately studied. Methods. Of 4162 participants aged 65 and older enrolled in the Duke Established Populations for Epidemiologic Studies of the Elderly study in 1986, 376 of the participants self-reported a diagnosis of cancer. Participants were divided into 2 comorbidity groups and 4 cancer groups. Cancer groups included 132 participants diagnosed 0-4 years ago, 117 diagnosed 5-15 years ago, 127 diagnosed > 15 years ago, and 3784 participants who had never been diagnosed with cancer. Comorbidity (self-reported stroke, diabetes, hypertension, and myocardial infarction) was classified as presence of 1 or no comorbidities (n = 3089) or 2 or more comorbidities (n = 1073). Function was assessed by Katz Activities of Daily Living, Rosow-Breslau, Nagi, and Instrumental Activities of Daily Living scales at the time of interview. Results. In a two-way analysis of covariance model of comorbidity and cancer group controlling for age, race, sex, education, marital status, depression, and cognitive status, duration of cancer survivorship does not influence most measures of function. In the subset of 376 cancer survivors, comorbidity significantly correlates with the functional status of these older cancer survivors (<0.02, for all 4 measures of function). Conclusions. In the older cancer survivor, regardless of duration following diagnosis, the presence of comorbidity rather than the history of cancer per se correlates with impaired functional status.