Physical Performance and Subsequent Disability and Survival in Older Adults with Malignancy: Results from the Health, Aging and Body Composition Study

OBJECTIVES To evaluate objective physical performance measures as predictors of survival and subsequent disability in older patients with cancer. DESIGN Longitudinal cohort study. SETTING Health, Aging and Body Composition (Health ABC) Study. PARTICIPANTS Four hundred twenty-nine individuals diagnosed with cancer during the first 6 years of follow-up of the Health ABC Study. MEASUREMENTS The associations between precancer measures of physical performance (20-m usual gait speed, 400-m long-distance corridor walk (LDCW), and grip strength) and overall survival and a short-term outcome of 2-year progression to disability or death were evaluated. Cox proportional hazards and logistic regression models, stratified for metastatic disease, respectively, were used for outcomes. RESULTS Mean age was 77.2, 36.1% were women, and 45.7% were black. Faster 20-m usual walking speed was associated with a lower risk of death in the metastatic group (hazard ratio=0.89, 95% confidence interval (CI)=0.79-0.99) and lower 2-year progression to disability or death in the nonmetastatic group (odds ratio (OR)=0.77, 95% CI=0.64-0.94). Ability to complete the 400-m LDCW was associated with lower 2-year progression to disability or death in the nonmetastatic group (OR=0.24, 95% CI=0.10-0.62). There were no associations between grip strength and disability or death. CONCLUSION Lower extremity physical performance tests (usual gait speed and 400-m LDCW) were associated with survival and 2-year progression to disability or death. Objective physical performance measures may help inform pretreatment evaluations in older adults with cancer.