Daily life mobility detects frailty, falls, and functioning in older prostate cancer survivors treated with androgen deprivation therapy

Deanne C Tibbitts; Martina Mancini; Sydnee Stoyles; Nathan F Dieckmann; Julie N Graff; Mahmoud El-Gohary; Fay B Horak; Kerri M Winters-Stone

doi:10.1016/j.jgo.2024.102180

Daily life mobility detects frailty, falls, and functioning in older prostate cancer survivors treated with androgen deprivation therapy

J Geriatr Oncol. 2024 Dec 20;16(2):102180. doi: 10.1016/j.jgo.2024.102180. Online ahead of print.

Authors

Deanne C Tibbitts¹, Martina Mancini², Sydnee Stoyles³, Nathan F Dieckmann³, Julie N Graff⁴, Mahmoud El-Gohary⁵, Fay B Horak⁶, Kerri M Winters-Stone⁷

Affiliations

¹ Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA.
² Department of Neurology, Oregon Health & Science University, Portland, OR, USA.
³ School of Nursing, Oregon Health & Science University, Portland, OR, USA.
⁴ Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; VA Portland Health Care System, Portland, OR, USA.
⁵ APDM Wearable Technologies, Clario, Portland, OR, USA.
⁶ Department of Neurology, Oregon Health & Science University, Portland, OR, USA; APDM Wearable Technologies, Clario, Portland, OR, USA.
⁷ Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA; Division of Oncological Sciences, Oregon Health & Science University, Portland, OR, USA. Electronic address: wintersk@ohsu.edu.

PMID: 39708402
DOI: 10.1016/j.jgo.2024.102180

Abstract

Introduction: Androgen deprivation therapy (ADT) increases the risk of frailty, falls, and poor physical functioning in older adults with prostate cancer. Detection of frailty is limited to self-report instruments and performance measures, so unbiased tools are needed. We investigated relationships between an unbiased measure - daily life mobility - and ADT history, frailty, fall history, and functioning in older prostate cancer survivors treated with ADT.

Materials and methods: This cross-sectional study recruited prostate cancer survivors with a history of ADT from an exercise clinical trial, an academic medical center, and the community. Participants completed performance measures and surveys to assess frailty, fall history, and physical functioning, then wore instrumented socks for up to seven days to continuously monitor daily life mobility. We performed a principal component analysis on daily life mobility metrics and used regression analyses to investigate relationships between domains of daily life mobility and frailty, fall history, and physical functioning.

Results: Participants (N = 99) were aged 73.0 +/- 7.3 years, most were pre-frail or frail (75 %), and 35 % had fallen at least once in the last year. Daily life mobility metrics clustered into four domains: Gait Pace, Rhythm, Activity, and Balance. Worse scores on Rhythm and Activity were associated with increased odds of frailty (odds ratio [OR] 1.59, 95 % confidence interval [CI]: 1.04, 2.49 and OR 1.81, 95 % CI: 1.19, 2.83, respectively). A worse score on Rhythm was associated with increased odds of ≥1 falls in the previous year (OR 1.60, 95 % CI: 1.05, 2.47). Worse scores on Gait Pace, Rhythm, and Activity were associated with worse physical functioning. Mobility metrics were similar between current and past users of ADT.

Discussion: Continuous passive monitoring of daily life mobility may identify prostate cancer survivors who have developed frailty, falls, and declines in physical functioning.

Keywords: Androgen deprivation therapy; Falls; Frailty; Mobility; Physical functioning; Prostate cancer; Wearable electronic devices.