title: Motivation and mortality in older women with early stage breast cancer: A longitudinal study with ten years of follow-up.
abstract: The Getting Out of Bed Scale (GOB) was validated as a health-related quality of life (HRQoL) variable in older women with early stage breast cancer, suggesting its potential as a concise yet powerful measure of motivation. The aim of our project was to assess the association between GOB and mortality over 10years of follow-up.
  
  
  
  We studied 660 women ≥65-years old diagnosed with stage I-IIIA primary breast cancer. Data were collected over 10years of follow-up from interviews, medical records, and death indexes.
  
  
  
  Compared to women with lower GOB scores, women with higher GOB had an unadjusted hazard ratio (HR) of all-cause mortality of 0.78 at 5years, 95% confidence interval (CI) (0.52, 1.19) and 0.77 at 10years, 95%CI (0.59, 1.00). These associations diminished after adjusting for age and stage of breast cancer, and further after adjusting for other HRQoL variables including physical function, mental health, emotional health, psychosocial function, and social support. Unadjusted HRs of breast cancer-specific mortality were 0.92, 95%CI (0.49, 1.74), at 5years, and 0.82, 95%CI (0.52, 1.32), at 10years. These associations also decreased in adjusted models.
  
  
  
  Women with higher GOB scores had a lower hazard of all-cause mortality in unadjusted analysis. This effect diminished after adjusting for confounding clinical and HRQoL variables. GOB is a measure of motivation that may not be independently associated with cancer mortality, but reflects other HRQoL variables making it a potential outcome to monitor in older patients with cancer.
authors.affiliation: Internal Medicine Residency Program, Boston Medical Center, 72 East Concord Street, Evans 124, Boston, MA 02118, USA.
authors.forename: Clark
authors.initials: C
authors.lastname: Dumontier
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH 3012 Bern, Switzerland.
authors.forename: Kerri M
authors.initials: KM
authors.lastname: Clough-Gorr
authors.affiliation: Section of Geriatrics, Boston Medical Center/Boston University School of Medicine, 88 East Newton Street, Robinson Building, Boston, MA 02118, USA. Electronic address: rsillima@bu.edu.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Silliman
authors.affiliation: Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Stuck
authors.affiliation: Institute of Social and Preventive Medicine (ISPM), University of Bern, Finkenhubelweg 11, CH 3012 Bern, Switzerland; Department of Geriatrics, Inselspital, Bern University Hospital, and University of Bern, Switzerland.
authors.forename: André
authors.initials: A
authors.lastname: Moser
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009042:Motivation; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D011788:Quality of Life
keywords: Breast cancer; Disease-specific mortality; Geriatric oncology; Health-related quality of life; Mortality; Motivation; Quality of life; Risk stratification; Survivorship