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Frailty and comorbidities among young adult cancer survivors enrolled in an mHealth physical activity intervention trial

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Abstract

Purpose

The physical frailty phenotype identifies individuals at risk for adverse health outcomes but has rarely been assessed among young adult cancer survivors (YACS). This study describes frailty status among YACS participating in a physical activity (PA) intervention trial.

Methods

YACS were categorized at baseline using the 5-item FRAIL scale: fatigue; weight loss; illness; ambulation; resistance. Chi-square tests compared frailty and non-cancer comorbidities by characteristics. Prevalence rates (PRs) for the independent associations between characteristics, frailty, and comorbidities were estimated using modified Poisson regression models.

Results

Among 280 YACS (82% female; mean (M) age = 33.4 ± 4.8 years, M=3.7 ± 2.4 years post-diagnosis), 11% frail, 17% prefrail; the most frequent criteria were fatigue (41%), resistance (38%), and ambulation (14%). Compared to BMI < 25, higher BMI was associated with increased likelihood of frailty (BMI 25–30, PR: 2.40, 95% CI: 1.38–4.17; BMI > 30, PR: 2.95, 95% CI: 1.71–5.08). Compared to 0, ≥ 30 min/week of moderate-to-vigorous PA was associated with reduced frailty (PR: 0.39, 95% CI: 0.25–0.60). Most YACS (55%) reported ≥ 1 comorbidity, most frequently depression (38%), thyroid condition (19%), and hypertension (10%). Comorbidities were more common for women (59% vs. 37%) and current/former smokers (PR: 1.71, 95% CI: 1.29–2.28).

Conclusion

Prevalence of frailty and comorbidities in this sample was similar to other YACS cohorts and older adults without cancer and may be an indicator of accelerated aging and increased risk for poor outcomes.

Implications for Cancer Survivors

Assessment of frailty may help identify YACS at increased risk for adverse health outcomes.

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Acknowledgements

We would like to thank the members of the UNC Weight Research Program for their valuable support, including Brooke Nezami, Karen Hatley, Kristen Polzien, Molly Diamond, and Lindsey Camp.

Funding

Support for Erin Coffman was from the National Institutes of Health, National Cancer Institute (T32CA057726 to the Lineberger Comprehensive Cancer Center Cancer Education and Control Training Program); National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases (T32DK007686 to the UNC Nutrition Training Grant); This work was supported by National Institutes of Health, National Cancer Institute, Grant/Award Numbers: R01CA204965 (to CGV), P30CA016086; National Institute of Diabetes and Digestive and Kidney Diseases, Grant/Award Number: P30DK056350; Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, University Cancer Research Fund; National Center for Advancing Translational Sciences, Grant/Award Number: UL1TR002489.

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Authors and Affiliations

  1. Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Suite 136, Chapel Hill, NC, 27514, USA

    Erin M. Coffman, Erik A. Willis, Dianne S. Ward, Deborah F. Tate & Carmina G. Valle

  2. Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, USA

    Erin M. Coffman, Andrew B. Smitherman, Erik A. Willis, Deborah F. Tate & Carmina G. Valle

  3. School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA

    Andrew B. Smitherman

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Contributions

Conceptualization: E.M.C., A.B.S., E.A.W., D.S.W., D.F.T., C.G.V.; Methodology: E.M.C., A.B.S., E.A.W., D.S.W., D.F.T., C.G.V.; Formal analysis and investigation: E.M.C; Writing - original draft preparation: E.M.C; Writing - review and editing: E.M.C., A.B.S., E.A.W., D.S.W., C.G.V.; Funding acquisition: E.M.C., D.F.T., C.G.V.

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Correspondence to Erin M. Coffman.

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Coffman, E.M., Smitherman, A.B., Willis, E.A. et al. Frailty and comorbidities among young adult cancer survivors enrolled in an mHealth physical activity intervention trial. J Cancer Surviv (2023). https://doi.org/10.1007/s11764-023-01448-4

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