Dataset Information

Frailty and risk of mortality in older cancer survivors and adults without a cancer history: Evidence from the National Health and Nutrition Examination Survey, 1999-2014.

ABSTRACT:

Background

Epidemiologic evidence reporting the role of frailty in survival among older adults with a prior cancer diagnosis is limited.

Methods

A total of 2050 older adults (≥60 years old) surviving for at least 1 year after a cancer diagnosis and 9474 older adults without a cancer history from the National Health and Nutrition Examination Survey (1999-2014) were included for analysis. The exposure variable, a 45-item frailty index (FI), was categorized on the basis of validated cutoffs (FI ≤ 0.10 [fit], 0.10 < FI ≤ 0.21 [prefrail], and FI > 0.21 [frail]). All-cause mortality was ascertained via the National Death Index. Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence interval (CIs) for the FI, and this was followed by restricted cubic splines depicting dose-response curves.

Results

For older cancer survivors, the mean age at the baseline was 72.6 years (SD, 7.1 years); 5.9% were fit, 38.2% were prefrail, and 55.9% were frail. Older adults without a cancer history were slightly younger (mean age, 70.0 years) and less frail (47.9% were frail). At each level of the FI, cancer survivors (1.9 per 100 person-years for FI ≤ 0.10, 3.4 per 100 person-years for 0.10 < FI ≤ 0.21, and 7.5 per 100 person-years for FI > 0.21) had higher mortality than their cancer-free counterparts (1.4 per 100 person-years for FI ≤ 0.10, 2.4 per 100 person-years for 0.10 < FI ≤ 0.21, and 5.4 per 100 person-years for FI > 0.21). The multivariable model suggested a positive association between the FI and all-cause mortality for survivors (aHR for FI > 0.21 vs FI ≤ 0.10, 2.80; 95% CI, 1.73-4.53) and participants without a cancer history (aHR for FI > 0.21 vs FI ≤ 0.10, 2.75; 95% CI, 2.29-3.32). Restricted cubic splines indicated that all-cause mortality risk increased with the FI in a monotonic pattern.

Conclusions

Frailty is associated with a higher risk of death in older cancer survivors and the elderly without a cancer history.

SUBMITTER: Zhang D

PROVIDER: S-EPMC9671088 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Frailty and risk of mortality in older cancer survivors and adults without a cancer history: Evidence from the National Health and Nutrition Examination Survey, 1999-2014.

Zhang Dongyu D Mobley Erin M EM Manini Todd M TM Leeuwenburgh Christiaan C Anton Stephen D SD Washington Caretia J CJ Zhou Daohong D Parker Alexander S AS Okunieff Paul G PG Bian Jiang J Guo Yi Y Pahor Marco M Hiatt Robert A RA Braithwaite Dejana D

Cancer 20220524 15

<h4>Background</h4>Epidemiologic evidence reporting the role of frailty in survival among older adults with a prior cancer diagnosis is limited.<h4>Methods</h4>A total of 2050 older adults (≥60 years old) surviving for at least 1 year after a cancer diagnosis and 9474 older adults without a cancer history from the National Health and Nutrition Examination Survey (1999-2014) were included for analysis. The exposure variable, a 45-item frailty index (FI), was categorized on the basis of validated ...[more]

PMID: 35608563

Similar Datasets

Project description:BACKGROUND:Cigarette smoking is common in persons living with hepatitis C (hepatitis C+), but national statistics on this harmful practice are lacking. A better understanding of smoking behaviors in hepatitis C+ individuals may help in the development of targeted treatment strategies. METHODS:We extracted data from the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2014. Hepatitis C+ were compared with hepatitis C- adults in the entire sample and in the subset of current smokers. Measures included demographics, current smoking, cigarettes/day, nicotine dependence, other tobacco use, substance use, and medical and psychiatric comorbidities. RESULTS:Complete smoking and hepatitis C virus (HCV) data were available for 39,472 (90.1%) of 43,793 adult participants in NHANES during the study years. Hepatitis C+ smoked at almost triple the rate of hepatitis C- adults (62.4% vs 22.9%), with no significant difference between hepatitis C+ men and women (64.5% vs 58.2%). Hepatitis C+ smokers were more likely to smoke daily than hepatitis C- smokers (87.5% vs 80.0%), but had similar levels of nicotine dependence. Hepatitis C+ smokers were more likely to be older (mean age: 47.1 vs 41.5 years), male (69.4% vs 54.4%), Black (21.2% vs 12.1%), less educated (any college: 31.8% vs 42.9%), poor (mean family monthly poverty index: 1.80 vs 2.47), uninsured (43.9% vs 30.4%), use drugs (cocaine: 11.1% vs 3.2%; heroin: 4.0% vs 0.6%), and be depressed (33.2% vs 13.5%). Multivariate analyses revealed significant associations of both hepatitis C infection and cigarette smoking with current depression and hypertension. CONCLUSIONS:There is a cigarette smoking epidemic embedded within the hepatitis C epidemic in the United States. The sociodemographic profile of hepatitis C+ smokers suggests that the implementation of effective tobacco treatment will be challenging. Thoughtful treatment strategies that are mindful of the unique characteristics of this group are needed.

Project description:BackgroundWeight-adjusted waist circumference index (WWI) is a novel index related to obesity and has been associated with the risk and prognosis of several diseases. The aim of the study was to determine the association between WWI and myocardial infarction.MethodsThe study analyzed cross-sectional data from 31,535 participants derived from the 1999-2014 National Health and Nutrition Examination Survey (NHANES) dataset. Multiple logistic regression and restricted cubic spline (RCS) analyses were conducted to assess both linear and nonlinear associations between WWI and myocardial infarction. Subgroup analyses and interaction tests were also performed.ResultsAmong the 31,535 participants analyzed, 1,449 (4.82%) had experienced a myocardial infarction. The fully adjusted models demonstrated a positive association between WWI and myocardial infarction [odds ratio (OR) = 1.34, 95% confidence interval (CI): 1.13-1.58]. Individuals in the highest quartile of WWI were 81% more likely to suffer from a myocardial infarction compared to those in the lowest quartile (OR = 1.81, 95% CI: 1.24-2.63). The analysis employing restricted cubic spline modeling indicated a nonlinear positive correlation between WWI and myocardial infarction. The risk of myocardial infarction was 1.29 times higher when WWI was below 10.97 cm/√kg (OR = 2.29, 95% CI: 1.37-3.84). When WWI exceeded 10.97 cm/√kg, the upward trend in the risk of myocardial infarction significantly slowed with increasing WWI (OR = 1.26, 95%CI:1.03-1.56). A threshold WWI value of greater than 11.15 cm/√kg was identified for predicting myocardial infarction, outperforming waist circumference and body mass index (BMI). Subgroup analyses revealed that the impact of WWI on myocardial infarction varied across different populations. Interaction analyses demonstrated significant interactions between myocardial infarction incidence and WWI with age, hypertension, coronary heart disease, angina pectoris, and stroke (P for interaction <0.05), but not with gender, race, obesity, diabetes, or prediabetes and heart failure (P for interaction >0.05).ConclusionsThe findings suggest that there is a positive and non-linear association between WWI and the incidence of myocardial infarction. We recommend incorporating WWI into routine physical examinations and cardiovascular risk screening as an early warning mechanism. This may facilitate early identification of high-risk individuals and promote earlier preventive interventions.

Dataset Information

Frailty and risk of mortality in older cancer survivors and adults without a cancer history: Evidence from the National Health and Nutrition Examination Survey, 1999-2014.

Background

Methods

Results

Conclusions

Publications

Frailty and risk of mortality in older cancer survivors and adults without a cancer history: Evidence from the National Health and Nutrition Examination Survey, 1999-2014.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets