Prevalence of self-reported falls, balance or walking problems in older cancer survivors from Surveillance, Epidemiology and End Results—Medicare Health Outcomes Survey

Abstract

Objective To determine the prevalence of falls and balance/walking problems in the past 12 months among older cancer survivors before and after cancer diagnosis. Materials and Methods We analyzed cross-sectional data from individuals aged ≥ 65 years with first primary cancer from the Surveillance, Epidemiology, and End Results and Medicare Health Outcomes Survey (SEER-MHOS) linkage (n = 12,659). The first MHOS completed by each survivor from 0 to 2 years before cancer diagnosis to 1–4 years after cancer diagnosis were included. We estimated unadjusted and demographic-adjusted prevalence of falls and balance/walking problems for each type of cancer during five one-year time periods before and after cancer diagnosis. Results Adjusted prevalence of falls was significantly higher post-diagnosis than pre-diagnosis in prostate (12% during years 1–2 pre-diagnosis vs. 17%–20% during years 1–4 post-diagnosis)(p = 0.01) and lung cancer (17% during years 1–2 pre-diagnosis vs. 28% during years 1–2 post-diagnosis)(p = 0.019). Adjusted prevalence of balance/walking problems were significantly higher post-diagnosis than pre-diagnosis in non-Hodgkin's lymphoma (26% during years 1–2 pre-diagnosis vs. 45% during years 1–2 post-diagnosis)(p = 0.012), breast (32% during years 1–2 pre-diagnosis vs. 41% during years 3–4 post-diagnosis)(p = 0.001), prostate (22% during years 1–2 pre-diagnosis vs. 28%–29% during years 1–4 post-diagnosis)(p = 0.012), and lung cancer (33% during years 1–2 pre-diagnosis vs. 40% during year 0–1 pre-diagnosis and 46% during years 1–2 post-diagnosis)(p = 0.018). Prevalence did not differ across time periods in other cancers. Conclusions Falls and balance/walking problems may become more frequent after the diagnosis of some cancers. Screening, surveillance, and interventions need to consider functional deficits and cancer diagnosis.