Characteristics Associated With Physical Function Trajectories in Older Adults With Cancer During Chemotherapy

Context: Studies on physical function trajectories in older adults during chemotherapy remain limited.

Objectives: The objective of this study was to determine demographic, clinical, and symptom characteristics associated with initial levels as well as trajectories of physical function over two cycles of chemotherapy in adults aged ≥65 years with breast, gastrointestinal, gynecological, or lung cancer.

Methods: Older adults with cancer (n = 363) who had received chemotherapy within the preceding four weeks were assessed six times over two cycles of chemotherapy using the Short Form-12 Physical Component Summary (PCS) score. Hierarchical linear modeling was used to evaluate for interindividual variability in initial levels and trajectories of PCS scores.

Results: Mean age was 71.4 years (SD 5.5). Mean PCS score at enrollment was 40.5 (SD .45). On average, PCS scores decreased slightly (i.e., 0.21 points) at each subsequent assessment. Lower PCS scores at enrollment were associated with older age, greater comorbidity, being unemployed, lack of regular exercise, higher morning fatigue, lower evening energy, occurrence of pain, lower trait anxiety, and lower attentional function. Only higher morning fatigue and lower enrollment PCS scores were associated with decrements in physical function over time.

Conclusion: While several symptoms were associated with decrements in PCS scores at enrollment in older adults with cancer receiving chemotherapy, morning fatigue was the only symptom associated with decreases in physical function over time. Regular assessments of symptoms and implementation of evidence-based interventions should be considered to maintain physical function in older adults during chemotherapy.