TY - JOUR
T1 - Correlates of physical activity among older breast cancer survivors
T2 - Findings from the Women's Health Initiative LILAC study
AU - Krok-Schoen, Jessica L.
AU - Pennell, Michael L.
AU - Saquib, Nazmus
AU - Naughton, Michelle
AU - Zhang, Xiaochen
AU - Shadyab, Aladdin H.
AU - Kroenke, Candyce H.
AU - Bea, Jennifer W.
AU - Peterson, Lindsay L.
AU - Crane, Tracy
AU - Wactawski-Wende, Jean
AU - Paskett, Electra D.
N1 - Funding Information:
This study used data from the Women's Health Initiative (WHI) study and the subsequent WHI Life and Longevity After Cancer (LILAC) ancillary study, funded by the National Cancer Institute. Briefly, WHI was initiated in 1993, with the goal to evaluate approaches to prevent some cancers, heart disease, and osteoporotic fractures in 161,000 postmenopausal women [ 42–44 ]. Between 1993 and 1998, postmenopausal women, aged 50–79 years, were recruited from 40 clinical sites across the US into one or more randomized clinical trials (WHI-CT, n = 68,132) or an observational study (WHI-OS, n = 93,676). The WHI-CTs ended in 2004 and 2005, and all CT and OS participants were invited to continue survey-based follow-up in the WHI Extension Study 1 (2005–2010), Extension Study 2 (2010–2015), and Extension Study 3 (2015–2020). Beginning in 2013, the WHI LILAC Study enrolled WHI participants diagnosed with select cancers after WHI enrollment [ 45 ]. The WHI LILAC Study expanded the existing WHI data to support studies of cancer outcomes, participant survivorship, and molecular epidemiology. LILAC participants were surveyed annually about their cancer treatments, recurrences, medications, symptoms, social support, mental and physical functioning, quality of life, unmet needs, and finances.
Funding Information:
The WHI program is funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, U.S. Department of Health and Human Services through 75N92021D00001, 75N92021D00002, 75N92021D00003, 75N92021D00004, 75N92021D00005. The WHI Life and Longevity after Cancer (LILAC) study is funded by UM1 CA173642 and a grant to EDP from the Breast Cancer Research Foundation. XZ is supported by NCI F99 CA253745.
Funding Information:
Electra Paskett and Michelle Naughton disclosed that they have grant funding from the Merck Foundation. Electra Paskett also has grant funding from Pfizer. Michael Pennell is supported by grants from Pfizer and Sanofi. All other authors report no conflicts of interest.
Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2022/3
Y1 - 2022/3
N2 - Introduction: Physical activity can attenuate cancer-related declines in physical functioning, improve emotional well-being, and prolong survival among older (≥65 years) breast cancer survivors. However, factors associated with physical activity among older breast cancer survivors are not well-understood. Materials and methods: Participants were enrolled in the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study. Descriptive statistics, multiple linear regression, and relative risk [RR] regression were used to assess the association of demographic, clinical, physical and psychosocial variables with the total duration of and participation in physical activity among postmenopausal breast cancer survivors. Age-specific correlates (65–74 years vs. 75–84 years vs. ≥85 years) of physical activity were also examined. Results: The majority of participants (n = 3710, mean age = 78.8 ± 5.9) were white (90.7%) and had in situ/localized breast cancer (78.9%). Women who had higher education (RR = 1.47 for graduate/professional school versus high school or less, 95% CI: 1.32, 1.63), higher self-rated health (RR = 1.04 for 10 point increase, 95% CI:1.02, 1.07), higher physical functioning (RR = 1.03 for 5 point increase, 95% CI: 1.02, 1.04), and higher social support (RR = 1.41 for social support all of the time versus none of the time, 95% CI: 1.01, 1.96), were more likely to engage in any physical activity. Similar results were observed for duration of physical activity. Among women aged <75, radiation therapy, but not chemotherapy, was associated with longer duration of total physical activity (adjusted difference = 19.7 min/week, 95% CI: 6.1, 33.3), but was not associated with duration among older women. The association between pain and duration of moderate/strenuous activity also differed with age: among women aged <75, those with moderate pain averaged fewer minutes of moderate/strenuous physical activity than those with no pain (adjusted difference:−14.4 min/week, 95% CI:−28.5, −0.1). However, among women aged ≥85, those with moderate pain averaged more minutes of moderate/strenuous physical activity per week than those with no pain (adjusted difference:16.6 min/week; 95% CI:2.9, 30.3). Discussion: Multiple factors were associated with physical activity among older breast cancer survivors in the WHI. Future physical activity interventions should focus on age-related (e.g., comorbidities) and treatment-related factors (e.g., radiation) as well as certain subgroups, such as women with higher symptom burden.
AB - Introduction: Physical activity can attenuate cancer-related declines in physical functioning, improve emotional well-being, and prolong survival among older (≥65 years) breast cancer survivors. However, factors associated with physical activity among older breast cancer survivors are not well-understood. Materials and methods: Participants were enrolled in the Women's Health Initiative (WHI) Life and Longevity After Cancer (LILAC) study. Descriptive statistics, multiple linear regression, and relative risk [RR] regression were used to assess the association of demographic, clinical, physical and psychosocial variables with the total duration of and participation in physical activity among postmenopausal breast cancer survivors. Age-specific correlates (65–74 years vs. 75–84 years vs. ≥85 years) of physical activity were also examined. Results: The majority of participants (n = 3710, mean age = 78.8 ± 5.9) were white (90.7%) and had in situ/localized breast cancer (78.9%). Women who had higher education (RR = 1.47 for graduate/professional school versus high school or less, 95% CI: 1.32, 1.63), higher self-rated health (RR = 1.04 for 10 point increase, 95% CI:1.02, 1.07), higher physical functioning (RR = 1.03 for 5 point increase, 95% CI: 1.02, 1.04), and higher social support (RR = 1.41 for social support all of the time versus none of the time, 95% CI: 1.01, 1.96), were more likely to engage in any physical activity. Similar results were observed for duration of physical activity. Among women aged <75, radiation therapy, but not chemotherapy, was associated with longer duration of total physical activity (adjusted difference = 19.7 min/week, 95% CI: 6.1, 33.3), but was not associated with duration among older women. The association between pain and duration of moderate/strenuous activity also differed with age: among women aged <75, those with moderate pain averaged fewer minutes of moderate/strenuous physical activity than those with no pain (adjusted difference:−14.4 min/week, 95% CI:−28.5, −0.1). However, among women aged ≥85, those with moderate pain averaged more minutes of moderate/strenuous physical activity per week than those with no pain (adjusted difference:16.6 min/week; 95% CI:2.9, 30.3). Discussion: Multiple factors were associated with physical activity among older breast cancer survivors in the WHI. Future physical activity interventions should focus on age-related (e.g., comorbidities) and treatment-related factors (e.g., radiation) as well as certain subgroups, such as women with higher symptom burden.
KW - Breast cancer
KW - Geriatric oncology
KW - Older adults
KW - Physical activity
KW - cancer survivorship
UR - http://www.scopus.com/inward/record.url?scp=85120666806&partnerID=8YFLogxK
U2 - 10.1016/j.jgo.2021.11.012
DO - 10.1016/j.jgo.2021.11.012
M3 - Article
C2 - 34893462
AN - SCOPUS:85120666806
SN - 1879-4068
VL - 13
SP - 143
EP - 151
JO - Journal of Geriatric Oncology
JF - Journal of Geriatric Oncology
IS - 2
ER -