Sedentary lifestyle as a predictor of early death in older adults with cancer: A prospective cohort study with 2692 patients

Jurema Telles O. Lima,Maria Julia Goncalves Mello,Leticia telles Sales, Luis Filipe Miranda Dos Santos, Fernanda R. de Melo Silva, Rafael M. M. C. Rayol, Jose Roberto Silva, Jose Iran Costa, Mirella Rebello,Zilda Cavalcanti, Luiz Claudio Santos Thuler

JOURNAL OF CLINICAL ONCOLOGY(2023)

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摘要
12058 Background: Physical activity is an important aspect of the global health of older adults with cancer (OAC). The aim of this study was to determine sedentary lifestyle as a predictor of early death in OAC. Methods: Prospective cohort involving elderly (60+) with cancer, cared for in a public hospital in Pernambuco, from January 2015 to December 2021. Sociodemographic, clinical, and lifestyle variables were considered. The level of physical activity was assessed before cancer treatment by the International Physical Activity Questionnaire (IPAQ), short version, with classification into active (active/very active) and inactive (sedentary/inadequately active) and comprehensive geriatric assessment (CGA). The outcome was death within 180 days. Kaplan-Meier survival curves and Cox multivariate analysis were performed. Results: 2692 patients were included, most were men, with family income less than 01 minimum wage in almost 30%. The presence of two or more comorbidities was observed in 70.1% of patients. The main primary sites were prostate (30.8%), breast (17%) and digestive system (25.8%), gynecological system (10.6%), lung (5.9%), and the majority (67.6%) had no metastatic disease. There were 461 deaths (25.7% sedentary and 9.7% non-sedentary). Sedentary lifestyle was an independent risk factor for early death (HR=1.28,95% CI=1.07-1.64 p< 0.036), controlled by tumor topography and presence or absence of metastasis, presence of polypharmacy and Karnofsky performance scale, recent hospitalization and nutritional status. At 180 days, survival among patients with some level of physical activity was higher (90% (0.88 - 0.92)) than among sedentary patients (74% (0.72 - 0.77, p < 0.01). Conclusions: Sedentary lifestyle at the time of cancer diagnosis was an independent risk factor for early death among Older adults with cancer. Encouraging physical activity is an important public health action to face aging-related health problems, such as cancer.
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关键词
sedentary lifestyle,cancer,older adults,early death,cohort study
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