Prevalence of Functional Limitations and their Associations with Systemic Cancer Therapy among Older Adults in Nursing Homes with Advanced Non-Small Cell Lung Cancer

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• Alternative Title:
  J Geriatr Oncol
• Personal Author:
  Panagiotou, Orestis A. ; Keeney, Tamra ; Ogarek, Jessica A. ; Wulff-Burchfield, Elizabeth ; Olszewski, Adam J. ; Bélanger, Emmanuelle
• Description:
  Objectives:
  
  To determine the relationship of self-care task disabilities with the use of systemic cancer therapies for advanced non-small cell lung cancer (NSCLC) in nursing home patients.
  
  Materials and Methods:
  
  Using the Surveillance, Epidemiology, and End Results-Medicare database linked with Minimum Data Set assessments, we identified nursing home residents with advanced NSCLC from 2011–2015. We considered disability in activities of daily living (ADL) including dressing, personal hygiene, toilet use, locomotion on unit, transfer, bed mobility, and eating. We estimated the association between ADL disabilities and receipt of systemic cancer therapies within 3 months of diagnosis.
  
  Results:
  
  Of the 3,174 patients, 2,702 (85.2%) experienced disability in one or more ADLs and 64.7% had disability in 5–7 ADLs. A total of 415 (13.1%) patients received systemic therapy. There was a strong association between disability in each ADL and receipt of therapy including dressing (OR, 0.52 [95% CI, 0.42–0.65]), toileting (odds ratio, OR, 0.52 [95% confidence interval, CI, 0.42–0.65]), personal hygiene (OR, 0.48 [95% CI, 0.39–0.59]), transfers (OR, 0.51 [95% CI, 0.41–0.64]), bed mobility (OR, 0.55 [95% CI, 0.44–0.69]), locomotion (OR, 0.57 [95% CI, 0.46–0.71]), or eating (OR, 0.45 [95% CI, 0.31–0.67]). Compared to patients having no ADL disability, patients were less likely to receive chemotherapy if they had disability in 1–2 ADLs (OR, 0.95 [95% CI, 0.66–1.37]), 3–4 ADLs (OR, 0.81 [95% CI, 0.56–1.15]), or 5–7 ADLs (OR, 0.43 [95% CI, 0.33–0.56]).
  
  Conclusions:
  
  Systemic cancer therapy is not commonly used in this population and is strongly predicted by disability in self-care tasks.
  
  
• Subjects:
  Activities Of Daily Living Aged Article Carcinoma, Non-Small-Cell Lung Functional Status Humans Lung Cancer Lung Neoplasms Medicare Nursing Homes Prevalence United States

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• Source:
  J Geriatr Oncol. 12(5):765-770
• Pubmed ID:
  33610505
• Pubmed Central ID:
  PMC8184570
• Document Type:
  Journal Article
• Funding:
  HHSN261201000035C/CA/NCI NIH HHSUnited States/ ; UG1 CA189828/CA/NCI NIH HHSUnited States/ ; HHSN261201000035I/CA/NCI NIH HHSUnited States/ ; U58 DP003862/DP/NCCDPHP CDC HHSUnited States/ ; T32 HS000011/HS/AHRQ HHSUnited States/ ; HHSN261201000140C/CA/NCI NIH HHSUnited States/ ; R01 AG054656/AG/NIA NIH HHSUnited States/ ; P01 AG027296/AG/NIA NIH HHSUnited States/ ; HHSN261201000034C/CA/NCI NIH HHSUnited States/
• Volume:
  12
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f44d318af5be1d5c64e26056b34c0248e2a9b74b0b7ee4adf4058de9cc90b0a7
• Download URL:
  https://stacks.cdc.gov/view/cdc/117906/cdc_117906_DS1.pdf
• File Type:
  [PDF - 615.69 KB ]