ArticleJournal of the National Cancer Institute2021
Deficit Accumulation Frailty Trajectories of Older Breast Cancer Survivors and Non-Cancer Controls: The Thinking and Living With Cancer Study.
Article in Journal of the National Cancer Institute, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 2 of them syntheses that pooled it.
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Who cites it
42 citing papers in PubMed, 2 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Associations of frailty with symptoms, and HRQOL in older cancer survivors after cancer treatments: a systematic review and meta-analyses.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2024Pooled it
- The prevalence of frailty among breast cancer patients: a systematic review and meta-analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Pooled it
- Loneliness and mental health during the COVID-19 pandemic in older breast cancer survivors and noncancer controls.Cancer · 2021Trial
- Enhanced MobileNet with multi-scale feature fusion for automated breast cancer histopathology classification.Scientific reports · 2026Article
- Article
- Longitudinal dynamics of post-diagnosis frailty among older women with ovarian cancer.Gynecologic oncology · 2026Article
- Effects of frailty on cognitive function in breast cancer patients: the mediating roles of nutrition and depressive symptoms.Journal of cancer survivorship : research and practice · 2026Article
- Neighborhood deprivation on increasing deficit accumulation in older breast cancer survivors and noncancer control individuals.Journal of the National Cancer Institute · 2026Article
- Phenotypic, functional and metabolic features of B cells from a small cohort of breast cancer patients.Frontiers in oncology · 2026Article
- Frailty level, cancer history and healthcare utilization among older adults: Results from the US National Health Interview Survey.Asia-Pacific journal of oncology nursing · 2025Article
- Profile of biological aging in first primary cancers: a pan-cancer analysis of two large-scale cohorts from the UK and Hong Kong.BMC medicine · 2025Article
- Mapping the Final Journey: End-Of-Life Frailty Trajectories and Cause of Death.Journal of the American Geriatrics Society · 2025Article
- Depressive symptom trajectories in older breast cancer survivors: the Thinking and Living with Cancer Study.Journal of cancer survivorship : research and practice · 2025Article
- Gerotherapeutics: aging mechanism-based pharmaceutical and behavioral interventions to reduce cancer racial and ethnic disparities.Journal of the National Cancer Institute · 2025Review
- The development and validation testing of a comprehensive frailty assessment in women with breast cancer.BMC women's health · 2025Article
- The National Cancer Institute clinical trials planning meeting to address gaps in observational and intervention trials for cancer-related cognitive impairment.Journal of the National Cancer Institute · 2025Article
- Frailty trajectories and their determinants in cancer patients undergoing immunotherapy: a prospective longitudinal study.Frontiers in oncology · 2025Article
- Physical activity and cognition: longitudinal findings from the Thinking and Living with Cancer Study.Journal of the National Cancer Institute · 2024Article
- Cognitive function is mediated by deficit accumulation in older, long-term breast cancer survivors.Journal of cancer survivorship : research and practice · 2024Article
- Development and validation of a prediction model for frailty in breast cancer patients with extended survival.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
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Authors and funding
16 authors at 9 institutions in 1 country.
Funding
Abstract
backgroundWe evaluated deficit accumulation and how deficits affected cognition and physical activity among breast cancer survivors and non-cancer controls.
methodsNewly diagnosed nonmetastatic survivors (n = 353) and matched non-cancer controls (n = 355) ages 60-98 years without neurological impairments were assessed presystemic therapy (or at enrollment for controls) from August 2010 to December 2016 and followed for 36 months. Scores on a 42-item index were analyzed in growth-mixture models to determine deficit accumulation trajectories separately and combined for survivors and controls. Multilevel models tested associations between trajectory and cognition (FACT-Cog and neuropsychological tests) and physical activity (IPAQ-SF) for survivors and controls.
resultsDeficit accumulation scores were in the robust range, but survivors had higher scores (95% confidence intervals [CI]) than controls at 36 months (0.18, 95% CI = 0.16 to 0.19, vs 0.16, 95% CI = 0.14 to 0.17; P = .001), and averages included diverse deficit trajectories. Survivors who were robust but became frailer (8.8%) had similar baseline characteristics to those remaining robust (76.2%) but experienced a 9.6-point decline self-reported cognition (decline of 9.6 vs 3.2 points; P = .04) and a 769 MET minutes per week decline in physical activity (P < .001). Survivors who started and remained prefrail (15.0%) had self-reported and objective cognitive problems. At baseline, frail controls (9.5%) differed from robust controls (83.7%) on deficits and self-reported cognition (P < .001). Within combined trajectories, frail survivors had more sleep disturbances than frail controls (48.6% [SD = 17.4%] vs 25.0% [SD = 8.2%]; P = .05).
conclusionsMost survivors and controls remained robust, and there were similar proportions on a frail trajectory. However, there were differences in deficit patterns between survivors and controls. Survivor deficit accumulation trajectory was associated with patient-reported outcomes. Additional research is needed to understand how breast cancer and its treatments affect deficit accumulation.
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