ASPO Abstracts
Frailty and comorbidities among young adult cancer survivors in a mobile physical activity intervention trial
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2023
Abstract Body:
Purpose: The physical frailty phenotype identifies individuals at risk for adverse health outcomes but has rarely been assessed among young adult cancer survivors (YACS). This cross-sectional analysis estimated the prevalence of frailty and comorbidities and examined their associations with baseline characteristics of 280 YACS participating in a mobile physical activity (PA) intervention trial. Methods: We used the FRAIL index (fatigue; resistance (i.e., difficulty with stairs); ambulation (i.e., difficulty walking); illness; and weight loss; pre-frail = 2, frail ≥ 3 components). We compared frailty status and comorbidity percentages by baseline characteristics using chi-square tests. We estimated prevalence ratios (PR) for the independent association between participant characteristics, frailty status, and comorbidities using Poisson regression models. Results: YACS (82% female, M=33.4±4.8 yrs, M=3.7±2.4 yrs post-diagnosis) completed questionnaires at baseline. The prevalence of frailty was 14% and prefrailty 24%; the most frequently reported components were fatigue (70%), resistance (38%), and ambulation (14%). Prevalence of frailty/prefrailty was associated with BMI >25 (BMI 25-30, PR 1.66, 95% CI: 1.00-2.77; BMI >30, PR: 2.26, 95% CI: 1.42-3.60). Self-reported moderate-to-vigorous PA (compared to none) was associated with reduced likelihood of frailty (1-<60 min/wk, PR: 0.56, 95% CI: 0.35-0.80; 60+ min/wk, PR 0.61, 95% CI: 0.40-0.91). Most (55%) YACS reported >1 comorbidity; depression (38%), thyroid condition (19%), and hypertension (10%) were most frequently reported. Men were less likely to report >1 comorbidity (37% vs. 59%; PR 0.63, 95% CI: 0.42-0.93).) Treatment with surgery plus chemotherapy or radiation (PR 1.75, 95% CI: 1.08-2.80), BMI >30 (PR 1.33, 95% CI: 1.00-1.76), and being a current/former smoker (PR 1.31, 95% CI: 1.02-1.67) were associated with increased likelihood of >1 comorbidity. Conclusion: Prevalence of frailty and comorbidities among YACS enrolled in a PA intervention trial was similar to other YACS cohorts and may be an indicator of increased risk for poor outcomes. Future lifestyle interventions should consider targeting determinants of frailty and consider how frailty modifies the effects of lifestyle interventions in YACS.
Keywords: Adolescent and young adult cancer, survivorship, frailty, comorbidities