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Function, cognition, and quality of life among older adults with lung cancer who live alone: A prospective cohort study.
Singhal, Surbhi; Walter, Louise C; Smith, Alexander K; Boscardin, W John; Shi, Ying; Cohen, Harvey Jay; Presley, Carolyn J; Kushi, Lawrence H; Giri, Smith; Magnuson, Allison; Williams, Grant R; Velazquez, Ana I; Lee, Howard J; Sakoda, Lori C; Quesenberry, Charles P; Falvey, Jason R; Van Dyk, Kathleen M; Wong, Melisa L.
Afiliación
  • Singhal S; Division of Hematology/Oncology, Department of Medicine, University of California, Davis, Sacramento, CA, USA.
  • Walter LC; Division of Geriatrics, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
  • Smith AK; Division of Geriatrics, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
  • Boscardin WJ; Division of Geriatrics, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
  • Shi Y; Division of Geriatrics, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
  • Cohen HJ; Center for the Study of Aging & Human Development and Duke Cancer Institute, Duke University, Durham, NC, USA.
  • Presley CJ; Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA.
  • Kushi LH; Division of Research, Kaiser Permanente Northern California, The Permanente Medical Group, Oakland, CA, USA.
  • Giri S; Divisions of Hematology/Oncology and Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA.
  • Magnuson A; James P. Wilmot Cancer Institute, Division of Hematology/Oncology, Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
  • Williams GR; Divisions of Hematology/Oncology and Gerontology, Geriatrics, and Palliative Care, The University of Alabama at Birmingham, Birmingham, AL, USA.
  • Velazquez AI; Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
  • Lee HJ; Division of Hematology/Oncology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
  • Sakoda LC; Division of Research, Kaiser Permanente Northern California, The Permanente Medical Group, Oakland, CA, USA.
  • Quesenberry CP; Division of Research, Kaiser Permanente Northern California, The Permanente Medical Group, Oakland, CA, USA.
  • Falvey JR; Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA.
  • Van Dyk KM; Division of Geriatric Psychiatry, Department of Psychiatry, University of California, Los Angeles Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA.
  • Wong ML; Division of Geriatrics, University of California, San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Division of Research, Kaiser Permanente Northern California, The Permanente Medical Group, Oakland, CA, USA. Electronic address: melisa.wong@kp.org.
J Geriatr Oncol ; 15(8): 102068, 2024 Sep 16.
Article en En | MEDLINE | ID: mdl-39288505
ABSTRACT

INTRODUCTION:

Among older adults without cancer, living alone is associated with poor health outcomes. However, among older adults with non-small cell lung cancer (NSCLC) who live alone, data on function, cognition, and quality of life (QOL) during systemic treatment remain limited. MATERIALS AND

METHODS:

We enrolled adults aged ≥65 with advanced NSCLC starting a new chemotherapy, immunotherapy, and/or targeted therapy regimen with non-curative intent. Patients completed geriatric assessments including instrumental activities of daily living (IADL), Montreal Cognitive Assessment, and QOL pretreatment and at 1, 2, 4, and 6 months, or until treatment discontinuation, whichever occurred earlier. We categorized change in IADL, cognition, and QOL as stable/improved, declined with recovery, or declined without recovery using clinically meaningful definitions of change. We used multinomial logistic regression to compare change between patients who lived alone versus with others.

RESULTS:

Among 149 patients, median age was 73; 21% lived alone. Pretreatment IADL, cognition, and QOL scores were similar between older adults who lived alone versus with others. During NSCLC treatment, older adults who lived alone had similar trajectories of function (52% functional decline vs 38%), cognition (43% cognitive decline vs 50%), and QOL (45% QOL decline vs 44%) compared with those who lived with others. In unadjusted analyses, patients who lived alone were more likely to develop functional decline with recovery (reference category stable/improved function) than those who lived with others (relative risk ratio 4.07, 95% CI 1.14-14.6, p = 0.03). However, this association was not observed after adjusting for age, race, prior NSCLC treatment, current treatment group, and pretreatment geriatric assessment differences. There were no differences in cognitive or QOL trajectories in unadjusted or adjusted analyses.

DISCUSSION:

Approximately half of older adults with advanced NSCLC who lived alone were able to maintain their function, cognition, and QOL during NSCLC treatment, which was similar to older adults who lived with others. Many older adults with advanced NSCLC who live alone can receive systemic treatment with individualized supportive care.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Geriatr Oncol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Geriatr Oncol Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Países Bajos