A prospective examination of change in executive function and physical activity in older breast cancer survivors.

对老年乳腺癌幸存者执行功能和身体活动变化的前瞻性检查。

• 批准号: 9538981
• 负责人: Danielle Tometich
• 金额: $ 4.23万
• 依托单位: INDIANA UNIV-PURDUE UNIV AT INDIANAPOLIS
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-06-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9538981
• 关键词: Adoption; Advanced Malignant Neoplasm; Affect; Age; Age-Years; Alleles; Apolipoprotein E; Behavioral; Breast; Breast Cancer survivor; Cancer Control; Cancer Survivor; Chronic Disease; Cognitive; Cohort Studies; Comorbidity; Data; Decision Making; Diabetes Mellitus; Diagnosis; Education; Effectiveness; Elderly; Enrollment; Executive Dysfunction; Fatigue; Female Breast Carcinoma; Financial compensation; Frequencies; Funding; Future; General Population; Genetic Status; Genotype; Geography; Grant; Guidelines; Habits; Health Benefit; Impaired cognition; Informal Social Control; Intervention; Leisures; Locales; Longitudinal Studies; Maintenance; Malignant Neoplasms; Mastectomy; Measures; Medical; Mental Health; Moods; Neuropsychological Tests; Obesity; Older Population; Participant; Patient Self-Report; Physical Function; Physical activity; Population; Prospective Studies; Race; Recording of previous events; Reporting; Research; Research Personnel; Risk; Risk Factors; Sampling; Self-control as a personality trait; Site; Subgroup; Survivors; Testing; Thinking; Time; Training; United States; Woman; Work; age effect; aged; base; breast lumpectomy; cancer diagnosis; cancer therapy; cardiovascular disorder risk; cardiovascular risk factor; cognitive function; cognitive training; executive function; follow-up; functional decline; improved; multiple chronic conditions; novel; pre-doctoral; prevent; prospective; secondary analysis; sedentary; social; theories

Project Summary/Abstract Chronic disease and declining physical function are significant problems facing the growing population of older breast cancer survivors. Physical activity can reduce the risk of developing chronic disease and prevent functional decline in older breast cancer survivors; however, only 25% of older cancer survivors meet national guidelines for physical activity. Evidence suggests that physical activity can improve executive and other cognitive functions in cancer survivors; however, executive functioning may also affect physical activity. Problems with executive function may interfere with self-regulatory abilities necessary to initiate and sustain physical activity habits. Although some support for this hypothesis has been found in older adults without cancer, researchers have not extended this work to older breast cancer survivors, a population at greater risk of cognitive decline compared to age-matched controls. If lowered executive function is associated with lower physical activity at follow-up, findings would support future physical activity interventions which include cognitive training or compensation strategies for lowered executive function. Additionally, several risk factors for accelerated cognitive decline in older breast cancer survivors have been proposed. These risk factors include older age, more advanced cancer stage, multiple comorbid medical conditions, and the presence of at least one ε4 allele in the APOE genotype. These risk factors may also impact the relationship between executive function and physical activity. The proposed study is a secondary analysis of a prospective study of older breast cancer survivors, the Thinking and Living with Cancer (TLC) cohort study (R01CA129769). The TLC study is the only large prospective examination of objective cognitive function in older breast cancer survivors before systemic cancer therapy and 1 and 2 years later as well as contemporaneously assessed controls. Measures at each time point include neuropsychological tests of executive function and self-reported physical activity. Objective physical activity data are also available for a subsample of participants. The primary aim of the proposed project is to examine two hypotheses regarding the association between executive function change and physical activity in 346 older (60+ years of age) breast cancer survivors during the two years post-diagnosis and 356 matched controls. The primary hypothesis is that executive function decline from baseline to year 1 will predict lower physical activity at year 2. The secondary hypothesis is that lower physical activity at year 1 will predict decline in executive function from year 1 to year 2. This study also aims to explore whether the relationship between executive function change and physical activity differs for breast cancer survivors with selected risk factors for accelerated cognitive decline. Results will inform future physical activity interventions in order to slow functional decline and reduce the burden of chronic disease.

项目摘要/摘要 慢性疾病和身体机能下降是面临年龄较大的人口不断增长的重大问题 乳腺癌存活。体育锻炼可以降低患慢性疾病的风险并防止 老年乳腺癌存活的功能下降；但是，只有25％的旧癌症生存生存会议 体育锻炼指南。有证据表明，体育锻炼可以改善执行和其他 癌症存活中的认知功能；但是，执行功能也可能影响体育锻炼。 执行功能的问题可能会干扰发起和维持所需的自我调节能力 体育锻炼习惯。尽管在没有癌症的老年人中发现了对这一假设的一些支持，但 研究人员尚未将这工作扩展到较老的乳腺癌存活，这是认知风险更大的人群 与年龄匹配的对照相比，下降。如果降低的执行功能与较低的身体有关 随访时的活动，发现将支持未来的体育活动干预措施，包括认知培训 或降低执行职能的补偿策略。此外，加速的几个风险因素 已经提出了老年乳腺癌幸存者的认知能力下降。这些风险因素包括年龄较大， 更晚期的癌症阶段，多种合并症和至少一个ε4等位基因的存在 在APOE基因型中。这些风险因素也可能影响执行职能与 体育锻炼。拟议的研究是对旧乳腺癌前瞻性研究的次要分析 幸存者，癌症的思维和生活（TLC）同类研究（R01CA129769）。 TLC研究是唯一的 大量的前瞻性检查全身乳腺癌生存的旧乳腺癌的目标认知功能 癌症治疗以及1年后以及当代评估的对照。每次措施 点包括执行功能和自我报告的体育活动的神经心理学测试。客观物理 活动数据也可用于参与者的子样本。拟议项目的主要目的是 检查有关执行功能变化与体育活动之间关联的两个假设 在诊断后两年中，乳腺癌的346岁（60岁以上）乳腺癌的存活和356个匹配 控件。主要假设是从基线到第一年的执行功能下降将预测较低 第二年的体育锻炼。第二个假设是，第一年的体育活动降低将预测下降 从1年级到2年级的执行职能中。本研究还旨在探讨 执行功能变化和体育锻炼的乳腺癌存活情况有所不同，其中选定的风险因素 加速认知能力下降。结果将为未来的身体活动干预提供信息，以减慢功能 衰落并减少慢性疾病的燃烧。