ASPO Abstracts
Applying a Short Physical Performance Battery to Screen Older Survivors for Exercise Trials
Category: Lifestyles Behavior, Energy Balance & Chemoprevention
Conference Year: 2019
Abstract Body:
Purpose: To apply a validated short physical performance battery (SPPB) to verifyreadiness of older cancer survivors (ages 65+) to participate in exercise trials bycomparing differences in: 1) overall scores for survivors v. non-cancer controls and 2)functional capacity by cancer site that could inform screening and enhance trialparticipation.Methods: We used 2011 National Health and Aging Trends Survey (NHATS) data withcommunity-dwelling Medicare beneficiaries (n=5,676), incl. adults with cancer (n=1125,except non-melanoma cases). The SPPB assesses multiple functions, including standingbalance and gait speed, scored from 0 to 4 (0= worst;4=best), based on quartile cut-pointsfrom normative data. We calculated mean overall+subscores for all survivors and non-cancercontrols and analyzed using logistic regression models, controlling for age, gender,education, race/ethnicity, multimorbidity and BMI. Results: Overall SPPB mean scores for survivors were 1.56 (CI 1.5-1.6), compared to 1.65(CI 1.6-1.7) for non-cancer controls. Among survivors of breast (n=299), colorectal(n=103), gynecologic (n=108), prostate (n=318), bladder (n=44), kidney (n=35) and othercancers (n=218), prostate cancer survivors (PCS) had the highest overall performance score(1.86, CI 1.8-2). The lowest overall score was for gynecologic cancer cases (1.42, CI1.2-1.6). Also, PCS had the highest subscores for balance and gait speed with mean scoresof 2.57 and 2.48 respectively. Regression models revealed that older age (OR=0.9, CI0.882-0.905, p<0.05), being female (OR=0.8, CI 0.7-0.97, p<0.05), having BMI<18.5 (OR=0.7,0.4-1.1, p<0.05), black race (OR=0.5, CI 0.4-0.6, p<0.05), and greater co-morbidity(OR=0.1, CI 0.05-0.2, p <0.05) were less likely to perform well on SPPB measures. Conclusions: Survivors had worse function than non-cancer controls, which varied by cancersite and functional domain.PCS demonstrated the best scores overall + for balance andwalking speed. Women, especially, gynecologic survivors had the worst. Black race,multimorbidity and low weight were negatively associated with poor function. SPPB providesa robust tool to assess readiness of older survivors for exercise trials, and can be usedto tailor exercise programs to meet needs of older survivors.
Keywords: Older CancerSurvivors, clinicaltrialsPhysical performanceExercise Survivorship