Daily life mobility detects frailty, falls, and functioning in ADT-treated prostate cancer survivors

TL;DR

Daily life mobility can detect frailty, falls, and physical decline in prostate cancer survivors undergoing ADT.

Contribution

This study introduces daily life mobility as an unbiased tool to assess frailty and functioning in ADT-treated prostate cancer survivors.

Findings

Worse Rhythm and Activity mobility scores are linked to higher odds of frailty.

Poor Rhythm scores correlate with increased risk of falls in the past year.

Mobility metrics are similarly affected in current and past ADT users.

Abstract

Androgen deprivation therapy (ADT) increases the risk of frailty, falls, and, poor physical functioning in prostate cancer survivors. 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, falls, and functioning in ADT-treated prostate cancer survivors.

ADT-treated prostate cancer survivors (N=99) were recruited 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 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.

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 (OR 1.59, 95% 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.

Continuous passive monitoring of daily life mobility may identify prostate cancer survivors who have or are developing risk for frailty, falls, and declines in physical functioning.

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