Abstract
To examine and compare changes in strength and physical function from pre- to post-diagnosis among men with prostate cancer (PC, [cases]) and matched non-cancer controls identified from the Health, Aging and Body Composition (Health ABC) study. We conducted a longitudinal analysis of 2 strength and 3 physical function-based measures among both cases and controls, identified from a large cohort of community living older adults enrolled in the Health ABC study. We plotted trajectories for each measure and compared cases vs. controls from the point of diagnosis onwards using mixed-effects regression models. For cases only, we examined predictors of poor strength or physical function. We identified 117 PC cases and 453 matched non-cancer controls (50% African Americans). At baseline, there were no differences between cases and controls in demographic factors, comorbidities or self-reported physical function; however, cases had slightly better grip strength (44.6 kg vs. 41.0 kg, p<0.01), quadriceps strength (360.5 Nm vs. 338.7 Nm, p = 0.02) and Health ABC physical performance battery scores (2.4 vs. 2.3, p = 0.01). All men experienced similar declines in strength and physical function over an equivalent amount of time. The loss of quad strength was most notable, with losses of nearly two-thirds of baseline strength over approximately 7 years of follow up. Among both cases and controls, strength and physical function decline with increasing age. The largest declines were seen in lower body strength. Regular assessments should guide lifestyle interventions that can offset age- and treatment-related declines among men with PC.
Highlights
Prostate cancer (PC) is the most prevalent form of male cancer worldwide, with an estimated 174, 650 new cases being diagnosed in US men in 2018 [1]
There were no differences between cases and controls in demographic factors, comorbidities or self-reported physical function; cases had slightly better grip strength (44.6 kg vs. 41.0 kg, p
Active surveillance is a promising approach for low risk PC, yet a significant number of men still opt for more aggressive treatments such as surgery and radiation that often result in sexual, bowel and urinary dysfunction [3]
Summary
Prostate cancer (PC) is the most prevalent form of male cancer worldwide, with an estimated 174, 650 new cases being diagnosed in US men in 2018 [1]. The majority of men remain clinically asymptomatic and if diagnosed with low-risk disease may opt for active surveillance or treatment with surgery and/or radiation. Active surveillance is a promising approach for low risk PC, yet a significant number of men still opt for more aggressive treatments such as surgery and radiation that often result in sexual, bowel and urinary dysfunction [3]. These significant ongoing health-related quality of life (HRQL) challenges may cause men to become depressed, less-active and dis-engaged from activities of daily living (ADL’s)[4,5,6], which could further influence their physical HRQL. Comorbidity, body composition, lifestyle behaviors, and psycho-social well-being
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