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The association between food access and frailty among older adults with gastrointestinal malignancies-The CARE Registry.
Fowler, Mackenzie E; Harmon, Christian; Sharafeldin, Noha; Baker, Elizabeth; Oates, Gabriela; Nassel, Ariann; Clausing, Daniel; Giri, Smith; Williams, Grant R.
Afiliação
  • Fowler ME; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Harmon C; Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Sharafeldin N; Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Baker E; Department of Sociology, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Oates G; Department of Pediatrics, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Nassel A; Lister Hill Center for Health Policy, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Clausing D; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Giri S; Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Williams GR; Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Cancer ; 130(7): 1083-1091, 2024 04 01.
Article em En | MEDLINE | ID: mdl-38059840
BACKGROUND: Food access is associated with higher gastrointestinal (GI) cancer mortality; however, its association with frailty, which is a predictor of premature mortality among older adults with cancer, is less understood. METHODS: The authors included 880 adults aged 60 years and older who were recently diagnosed with GI cancers and were undergoing self-reported geriatric assessment at their first prechemotherapy visit to the University of Alabama at Birmingham oncology clinic. Food access was measured using the 2019 US Department of Agriculture Economic Research Service designation low-income, low-access (LILA), classifying census tracts based on income and/or access to food stores at various distances. The primary outcome was frailty on the CARE (Cancer and Aging Resilience Evaluation) Frailty Index, a composite of the proportion of impaired geriatric assessment measures. The authors examined the LILA-frailty association with modified Poisson regression accounting for census-tract clustering. RESULTS: The median patient age was 69 years, 58.1% were men, 22.5% were non-Hispanic Black, 29.2% had colorectal cancer, 28.0% had pancreatic cancer, 70.1% presented with stage III/IV disease, and 34.9% were frail. A higher proportion in LILA areas were non-Hispanic Black (44.1% vs. 10.8%; p < .001) and had less education (high school or less: 48.1% vs. 37.9%; p = .020). Adjusting for age, race and ethnicity, sex, cancer type and stage, and education, an LILA designation was associated with 58% greater odds of worsening frailty status (95% confidence interval, 1.18-2.12). An analysis of LILA subcategories revealed that associations were maintained across all LILA measures. CONCLUSIONS: Poor food access was associated with a greater risk of frailty among newly diagnosed older adults with GI cancers before they received systemic treatment. Intervening on local food access, particularly in LILA areas, may be a target for improving rates of frailty and promoting health equity in this population.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fragilidade / Neoplasias Gastrointestinais Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Fragilidade / Neoplasias Gastrointestinais Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Cancer Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Estados Unidos