“Katz activities of daily living disability in older cancer survivors by age, stage, and cancer type”

Abstract

Purpose/objective: The purpose of this study was to describe ADL impairments using the Katz ADL Index by cancer type, stage, and age in older cancer survivors. Methods: Cross-sectional data from cohorts 9-14 (year 2006-2013) of the Surveillance, Epidemiology and End Results national cancer registry and Medicare Health Outcomes Survey linkage were used to describe ADL performance using the Katz ADL Index. Mean Katz scores and frequency of ADL disability were reported across cancer types for all eight cancers (colon, lung, breast, prostate, bladder, kidney, non-Hodgkin’s lymphoma, uterine) and by stage and age for the four large cancers (colon, lung, breast, prostate). Results: In this sample of 6,973 cancer survivors, ADL deficits were the greatest in uterine cancer survivors (μ = 4.72, SD = 1.44). When considering age, Katz scores were most impaired in breast (μ = 3.90, SD = 1.93) and prostate survivors (μ = 4.35, SD = 1.84) age > 85 years. When considering stage, Katz scores were most impaired in stage four survivors of prostate (μ = 4.14, SD = 1.82) or breast (μ = 4.43, SD = 2.05) cancer. Across all cancer types and age groups, with the exception of stage 4 prostate cancer, ADL deficits were consistently impaired in the same order, from most impaired to least: continence, transfers, bathing, dressing, toileting, and, lastly, feeding. Conclusions: Screening for ADL impairments is needed for older cancer survivors as Katz ADL disability differs by cancer type, stage, and age with greater impairment with advanced age and stage. Implications for cancer survivors: Interventions to address ADL limitations should be considered for older cancer survivors.