Cancer survivors are living longer, but continue to encounter physical, psychosocial, and economic impacts of their cancer until the end of life. Of all types of injuries, falls pose the most serious threat to quality of life in the elderly, and consequently in elderly cancer survivors. There is a gap in the literature with few studies focusing on falls subsequent to cancer. The hypothesis in this proposal is that community dwelling elderly cancer survivors experience the influence of the disease or treatment of cancer, and have increased falls, fall sequelae, and use of healthcare. The plan in this proposal is: to conduct an analysis of data from the Michigan Home and Community Based Services program combined with information from the Cancer Registry, and Medicare and Medicaid claims. This study will explore, compare and contrast falls, fall sequelae, and healthcare use in those with and without a cancer diagnosis in community dwelling elderly patient population.
Specific aims i nclude: 1) After adjusting for age, sex, race/ethnicity, medications, comorbidities, ADLs, cognition, depression, incontinence, weight loss, and number of falls in the year prior to cancer diagnosis, to determine the extent to which: patients with a cancer diagnosis experience a greater number of falls, fractures, ER use, hospitalization, or nursing home placement, in the year following the cancer diagnosis compared to those patients with no diagnosis of cancer;and if there are differences in the number of falls among cancer patients in the year following diagnosis according to site of cancer (breast, colon, prostate, lung, or hematological), stage of cancer (I-IV.), or cancer treatment (chemotherapy and/or radiation);and 2) to examine if the effects of frailty (ADL, cognition, depression, incontinence, weight loss) on falls in the year after diagnosis are different with respect to site of cancer (breast, colon, prostate, lung, or hematological), stage of cancer, or cancer treatment (chemotherapy and/or radiation). Moreover, social factors will be described. The statistical approaches that accommodate the variables in this study are longitudinal Generalized Linear models and Generalized Estimating Equations. If falls, fall sequelae, or healthcare use in cancer survivors are different, then gerontological clinicians could focus on standardize fall risk assessment, and implement behavioral and psychological interventions to prevent falls. Accordingly, inclusion of fall prevention measures may be needed in Cancer Survivorship Care Planning mechanisms, to attempt to reduce the occurrence of falls in cancer survivors. Falls will become more important as the elderly cancer survivors population increases in size and health care costs continue to rise.
This research proposal is important to the health of elderly cancer survivors. If it is found that those who have a cancer diagnosis fall more often than those who do not have cancer, healthcare provides could target interventions to those who are most in need.
| Spoelstra, Sandra L; Given, Barbara A; Schutte, Debra L et al. (2013) Do older adults with cancer fall more often? A comparative analysis of falls in those with and without cancer. Oncol Nurs Forum 40:E69-78 |
| Spoelstra, Sandra L; Given, Barbara A; Given, Charles W (2012) Fall prevention in hospitals: an integrative review. Clin Nurs Res 21:92-112 |
| Spoelstra, Sandra Lee; Given, Barbara; You, Mei et al. (2012) The contribution falls have to increasing risk of nursing home placement in community-dwelling older adults. Clin Nurs Res 21:24-42 |
| Spoelstra, Sandra; Given, Barbara; von Eye, Alexander et al. (2010) Fall risk in community-dwelling elderly cancer survivors: a predictive model for gerontological nurses. J Gerontol Nurs 36:52-60 |
| Spoelstra, Sandra; Given, Barbara; von Eye, Alexander et al. (2010) Falls in the community-dwelling elderly with a history of cancer. Cancer Nurs 33:149-55 |
