Strength Training in Older Cancer Survivors in Pennsylvania

Abstract

BACKGROUND: Older survivors experience physical deterioration from aging and cancer treatment. Strength training (ST) may mitigate symptoms but is underutilized. The extent to which physical limitations from chronic conditions (“multimorbidity”) affect ST participation in older survivors is not well known. The purpose of this paper is to: 1) describe ST participation among older cancer survivors (≥55 years) by cancer site and; 2) assess the relationship of multimorbidity and ST in older cancer survivors. METHODS: We analyzed data from older survivors (n=485), identified from the Pennsylvania Cancer Registry, who were mailed a BRFSS-based questionnaire. Per ACSM guidelines, we operationalized ST participation as ≥2 sessions/week. We created age-groups (e.g., 55-64, 65-74, 75+) and a composite score of 7 common conditions (e.g., COPD, heart disease) to assess multimorbidity. Logistic regression estimated the association of demographic and behavioral risk factors (e.g., multimorbidity) with ST participation. RESULTS: Most respondents were female (62%), older (mean 69 years; range 55-95 years) and represented diverse cancer sites, including breast (n=106), gynecologic (n=99), prostate (n=119), colorectal (n=90) and lung (n=71) cancer survivors. ST participation was generally low; 75% of survivors reported no ST. Among those reported doing ST, survivors reported a mean ST frequency of 2.8 times/week (SE 2.8; CI 2.5,3.8), varying by cancer site/age. Gynecologic (OR=0.10, p<.05; CI 0.107-1.01) and prostate cancer survivors (OR=0.10, p<.05; CI 0.01, 0.95) were less likely to report doing ST than breast cancer survivors. We observed that older survivors with 3 comorbid conditions were less likely (OR=0.23, p=.10; CI 0.43,1.32) than survivors with fewer conditions to do ST, controlling for covariates. CONCLUSION: Uptake of recommended ST is suboptimal in older survivors. Older gynecologic and prostate survivors, and those with greater multimorbidity (i.e. score=3) may have greater difficulty achieving recommended ST than survivors of other sites or with less comorbidity. Designing interventions for survivors with unique barriers, such as gynecologic and prostate cancer survivors and those with greater multimorbidity, may help these older survivors to use ST to improve symptoms and quality of life.