title: Physical resilience of older cancer survivors: An emerging concept.
abstract: To characterize factors contributing to physical resilience in older cancer survivors, as demonstrated by resistance to decline or recovery (resilience).
  
  
  
  We conducted a secondary analysis of data from a randomized controlled trial of cancer survivors ≥65years old and ≥5years from cancer diagnoses. Physical function was assessed quarterly over 2years, with Short-Form 36 physical function subscale. Participants with ≥2 follow-up assessments (n=594) were evaluated for physical resilience: 1) Resistance was defined as lack of any decline, where decline was a drop of ≥13 points, and 2) resilience (i.e., recovery) was defined as regaining ≥50% of lost function, subsequent to decline.
  
  
  
  Mean age was 73.1years and 89.1% were Caucasian. Forty-nine percent (n=289) were resistant to decline in function; these individuals were younger, had higher education and income, were more likely to be Caucasian, and had higher baseline physical function (mean difference [MD] 7.8 points, 95% CI 5.0-10.8) and general health (MD 7.5 points, 95% CI 4.9-10.1). Fifty-seven percent (n=137 of 239) demonstrated resilience, with 91.2% (n=125) recovering within 6months of declines; these participants had higher baseline physical function (MD 6.6 points, 95% CI 1.8-11.4), but similar pre-decline function. More participants who were resistant, and more who showed resilience, reported high self-efficacy and social support.
  
  
  
  The majority of older cancer survivors exhibited physical resilience; this was associated with high baseline health, physical function, self-efficacy, and social support. Assessing and targeting psychosocial factors may be important for interventions seeking to promote physical resilience.
authors.affiliation: Health Services Research and Development, Durham VA Medical Center, Durham, NC, USA; Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA. Electronic address: wei.duan-porter@duke.edu.
authors.forename: Wei
authors.initials: W
authors.lastname: Duan-Porter
authors.affiliation: Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA; Duke University Center for the Study of Aging and Human Development, Durham, NC, USA; Geriatrics Research, Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA.
authors.forename: Harvey J
authors.initials: HJ
authors.lastname: Cohen
authors.affiliation: Department of Preventive Medicine, Department of Nutrition Sciences, University of Alabama, Birmingham, AL, USA; Comprehensive Cancer Center, University of Alabama, Birmingham, AL, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Demark-Wahnefried
authors.affiliation: Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA; Duke University Center for the Study of Aging and Human Development, Durham, NC, USA; Geriatrics Research, Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Sloane
authors.affiliation: Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA; Duke University Center for the Study of Aging and Human Development, Durham, NC, USA; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Jane F
authors.initials: JF
authors.lastname: Pendergast
authors.affiliation: Duke Office of Clinical Research, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Denise C
authors.initials: DC
authors.lastname: Snyder
authors.affiliation: Department of Medicine, Duke University School of Medicine, Durham, NC, USA; Duke University Claude D. Pepper Older Americans Independence Center, Durham, NC, USA; Duke University Center for the Study of Aging and Human Development, Durham, NC, USA; Geriatrics Research, Education and Clinical Center, Durham VA Medical Center, Durham, NC, USA.
authors.forename: Miriam C
authors.initials: MC
authors.lastname: Morey
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000073116:Cancer Survivors / Q000523:psychology*; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D020127:Recovery of Function; D055500:Resilience, Psychological; D020377:Self Efficacy; D012944:Social Support; D012959:Socioeconomic Factors; D014481:United States
keywords: Cancer survivors; Functional decline; Physical resilience; Recovery; Resistance