Patient-reported versus objectively-measured physical function and mortality risk among cancer survivors

Objective: This study aimed to characterize the relationship of patient-reported functional limitations, gait speed, and mortality risk among cancer survivors. Materials and Methods: This study included cancer survivors from the Third National Health and Nutrition Survey. Patient-reported functional limitations were quantified by asking participants to assess their ability to complete five tasks: (1) walking 1/4 mi, (2) walking up 10 steps, (3) stooping, crouching, or kneeling, (4) lifting or carrying an object of 10 lb, and (5) standing up from an armless chair. Gait speed was quantified using a 2.4-meter walk. Vital status was obtained through the United States National Center for Health Statistics. Results: The study sample included 428 cancer survivors who averaged 72.1 years of age. The average number of patient-reported functional limitations was 1.8 (out of 5) and 66% of participants reported >1 functional limitation. Patient-reported functional limitations and gait speed were related, such that each functional limitation associated with a -0.08 m/s slower gait speed (95% confidence interval: -0.10 to -0.06; P < 0.001). During a median follow-up of 11 years, 329 (77%) participants died. In multivariable-adjusted analysis, patient-reported functional limitations and survival were related, such that each additional reported functional limitation was associated with a 19% increase in the risk of death (95% confidence interval: 9% to 29%; P < 0.001). Conclusion: Patient-reported functional limitations are prevalent among cancer survivors, and associate with slower gait speeds and shorter survival. These data may provide increased insight on long-term prognosis and inform clinical decision-making by identifying subgroups of cancer survivors who may benefit from rehabilitative intervention. (C) 2016 Elsevier Ltd. All rights reserved.