Falls and physical performance deficits in older patients with prostate cancer undergoing androgen deprivation therapy. Urology 2008 Aug;72(2):422-7
Date
06/20/2008Pubmed ID
18561991Pubmed Central ID
PMC3032402DOI
10.1016/j.urology.2008.03.032Scopus ID
2-s2.0-48349102661 (requires institutional sign-in at Scopus site) 130 CitationsAbstract
OBJECTIVES: Men experience a decrease in lean muscle mass and strength during the first year of androgen deprivation therapy (ADT). The prevalence of falls and physical and functional impairment in this population have not been well described.
METHODS: A total of 50 men aged 70 years and older (median 78) receiving ADT for systemic prostate cancer (80% biochemical recurrence) underwent functional and physical assessments. The functional assessments included Katz's Activities of Daily Living (ADLs) and Lawton's Instrumental Activities of Daily Living (IADLs). Patients completed the Vulnerable Elder's Survey-13, a short screening tool of self-perceived functional and physical performance ability. Physical performance was assessed using the Short Physical Performance Battery. The history of falls was recorded. Of the 50 patients, 40 underwent follow-up assessment with the same instruments 3 months after the initial assessment.
RESULTS: Of the 50 men, 24% had impairment in the ADLs, 42% had impairment in the IADLs, 56% had abnormal Short Physical Performance Battery findings, and 22% reported falls within the previous 3 months. Within the Short Physical Performance Battery, deficits occurred within all subcomponents (balance, walking, and chair stands). On univariate analysis, age, deficits in ADLs and IADLs, and abnormal cognitive and functional screen findings were associated with an increased risk of abnormal physical performance. ADL deficits, the use of an assistive device, and abnormal functional screen findings were associated with an increased risk of falling.
CONCLUSIONS: The results of our study have shown that older men with prostate cancer receiving long-term ADT exhibit significant functional and physical impairment and are at risk of falls that is greater than that for similar-aged cohorts. Careful assessment of the functional and physical deficits in older patients receiving ADT is warranted.
Author List
Bylow K, Dale W, Mustian K, Stadler WM, Rodin M, Hall W, Lachs M, Mohile SGAuthor
Kathryn A. Bylow MD Associate Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
Accidental FallsActivities of Daily Living
Aged
Aged, 80 and over
Androgen Antagonists
Gonadotropin-Releasing Hormone
Humans
Male
Physical Fitness
Prostate-Specific Antigen
Prostatic Neoplasms
Risk Factors
Treatment Outcome
