Physical Activity and Quality of Life among Elderly Cancer Survivors Compared to Women without Cancer: The Iowa Women's Health Study

Abstract

Abstract Few studies have examined lifestyle factors and health-related quality of life (QOL) in elderly, long-term cancer survivors compared to a cancer-free comparison group. We examined the degree to which physical inactivity is associated with poor QOL among elderly, female cancer survivors compared to similar-aged women without cancer. Methods: Subjects included women enrolled in the Iowa Women's Health Study in 1986 who completed the 2004 questionnaire (at ages 71–89 years) and were alive through 2005. The 2004 questionnaire asked participants about recreational physical activity and included the Medical Outcomes Study Short Form-36 (SF36) QOL assessment. Physical inactivity was defined as moderate or vigorous activity less than once per week. Logistic regression was used to compute the odds of poor QOL for each SF36 subscale (<0.5 SD below the mean score of women without cancer) associated with physical inactivity between 4 groups based on the cross-classification of cancer history (no/yes) and physical inactivity (no/yes) (referent group = No/No). Results: Analyses included 12,067 women without a history of cancer and 1,707 women diagnosed with cancer between 1986 and 2002. Inactive cancer survivors were significantly more likely to report poor QOL for each SF36 subscale compared to the referent group (Odds Ratios (OR) 1.7 to 4.5), independent of age, comorbidity, BMI, and diet quality. Compared with the other 3 groups, inactive cancer survivors had the greatest odds of poor Physical Function (inactive cancer survivors [OR = 4.5, 95% CI 3.9–5.3], inactive women without cancer [OR = 3.8, 95% CI 3.5–4.2], active cancer survivors [OR = 1.0,95% CI 0.8–1.2]) and poor General Health (inactive cancer survivors [OR = 3.2, 95% CI 2.7–3.8], inactive women without cancer [OR = 2.8, 95% CI 2.5–3.0), active cancer survivors [OR = 1.2, 95% CI 0.98–1.4]). Among physically active women, cancer survivors had similar QOL as women without a cancer history. Conclusions: Physical inactivity was more strongly associated with poor General Health and Physical Function in elderly, long-term cancer survivors compared to women without cancer. These findings support the need for interventions to help older women maintain or regain a physically active lifestyle after a cancer diagnosis.