Use of physical performance measures to predict future disability and mortality in older cancer patients: The Health Aging and Body Composition Study (Health ABC)

Abstract

9553 Background: Optimal treatment for older cancer patients remains unclear due to a poor understanding of which clinical characteristics predict toxicity and survival. Our objective was to examine baseline physical performance measures as predictors of future disability or death in older adults with incident cancer diagnoses. Methods: Among 3,075 individuals aged ≥70 years participating in the Health ABC observational study, 431 had a confirmed cancer diagnosis in the first 6 years of follow-up. Measures of physical performance included usual gait speed over 20 meters, 400 meter long distance corridor walk, and grip strength. We assessed the relationship between measures of physical performance most closely preceding cancer diagnosis and progression to major disability or death at 2 years after diagnosis. Major disability is defined by any of the following: requiring cane or walker for ambulation, inability to walk a quarter mile and/or climb 10 steps, or requiring assistance with activities of daily living. 404 subjects had complete data for analysis. Logistic regression models were fit for each performance measure, adjusting for demographics, health habits, comorbidity, metastatic disease, and cancer type. Results: The mean age was 77.1±3.3 years; 35.6% were female; and 44.7% were black. Progression to disability or death at 2 years after diagnosis occurred in 45.7%. Mean gait speed was 1.2±0.2 meters/second (m/s) and mean grip strength was 33.7±11.9 kilograms. A 0.1 m/s faster usual gait speed on the 20 meter course was associated with a 15% decrease in risk of subsequent disability or death (OR=0.85, 0.74- 0.96). Individuals who completed the long distance corridor walk had a 66% decrease in risk of subsequent disability or death compared to those who were unable to complete the test (OR=0.34, 0.19–0.60). There was no association between grip strength and progression to disability or death (OR=0.98, 0.96–1.02). Conclusions: In our study of cancer patients aged ≥70years, pre-diagnosis physical performance is independently associated with progression to disability or death. These results suggest that simple performance tests may provide useful information in pre-treatment evaluations of older adults with cancer. No significant financial relationships to disclose.