Black-white disparity in physical performance among older women with newly diagnosed non-metastatic breast cancer: Exploring the role of inflammation and physical activity

Cynthia Owusu, Mark Schluchter, Siran M. Koroukian, Kathryn Schmitz, Nathan A. Berger

Research output: Contribution to journalArticle

Abstract

Objective: To examine racial differences in physical performance among older women with newly diagnosed non-metastatic breast cancer and identify clinical, behavioral and biological factors that might contribute to such disparities. Methods: This is a cross-sectional study of women aged ≥65 years with newly diagnosed stage I–III breast cancer recruited from ambulatory oncology clinics at an academic center, between September 2010 and August 2015. Participants completed a Comprehensive Geriatric Assessment and laboratory testing for biomarkers of inflammation [interleukin-6 (IL6)] prior to receiving systemic treatment for cancer. The primary outcome was poor physical performance, defined as scoring ≤7 on the Short Physical Performance Battery, Yes or No. Logistic regression analyses were undertaken. Results: Among 135 women with mean age of 74.8 years (SD = 6.9), 31% were African-American (AA), and 33% had poor physical performance. Controlling for age, education, comorbidities and geriatric syndromes, participants with poor physical performance were more likely to be AA [versus (vs.) Non-Hispanic Whites (NHW)], odds ratio (OR) = 3.10, 95% confidence interval (CI) = 1.18–8.15. Controlling further for physical activity (PA) attenuated the racial disparity in physical performance (OR = 2.50, CI = 0.91–6.84). Lastly, controlling for IL6 further diminished the racial disparity in physical performance (OR = 1.93, CI = 0.67–5.56). In adjusted models, PA and IL6 explained 29% and 38%, respectively, of the racial disparity in poor physical performance. Conclusion: Among older women with newly diagnosed non-metastatic breast cancer, poor physical performance was prevalent and AA were disproportionately affected. Less engagement in physical activity and subclinical inflammation partly contributed to this disparity.

Original languageEnglish (US)
Pages (from-to)613-619
Number of pages7
JournalJournal of Geriatric Oncology
Volume9
Issue number6
DOIs
StatePublished - Nov 1 2018

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African Americans
Exercise
Breast Neoplasms
Inflammation
Interleukin-6
Odds Ratio
Confidence Intervals
Geriatric Assessment
Biological Factors
Geriatrics
Comorbidity
Cross-Sectional Studies
Biomarkers
Logistic Models
Regression Analysis
Education
hydroquinone
Neoplasms
Therapeutics
3-methyl-N,N-diethyl-p-phenylenediamine

All Science Journal Classification (ASJC) codes

  • Oncology
  • Geriatrics and Gerontology

Cite this

@article{e56e4dc0855f4d11bb6bc2ed481b247c,
title = "Black-white disparity in physical performance among older women with newly diagnosed non-metastatic breast cancer: Exploring the role of inflammation and physical activity",
abstract = "Objective: To examine racial differences in physical performance among older women with newly diagnosed non-metastatic breast cancer and identify clinical, behavioral and biological factors that might contribute to such disparities. Methods: This is a cross-sectional study of women aged ≥65 years with newly diagnosed stage I–III breast cancer recruited from ambulatory oncology clinics at an academic center, between September 2010 and August 2015. Participants completed a Comprehensive Geriatric Assessment and laboratory testing for biomarkers of inflammation [interleukin-6 (IL6)] prior to receiving systemic treatment for cancer. The primary outcome was poor physical performance, defined as scoring ≤7 on the Short Physical Performance Battery, Yes or No. Logistic regression analyses were undertaken. Results: Among 135 women with mean age of 74.8 years (SD = 6.9), 31{\%} were African-American (AA), and 33{\%} had poor physical performance. Controlling for age, education, comorbidities and geriatric syndromes, participants with poor physical performance were more likely to be AA [versus (vs.) Non-Hispanic Whites (NHW)], odds ratio (OR) = 3.10, 95{\%} confidence interval (CI) = 1.18–8.15. Controlling further for physical activity (PA) attenuated the racial disparity in physical performance (OR = 2.50, CI = 0.91–6.84). Lastly, controlling for IL6 further diminished the racial disparity in physical performance (OR = 1.93, CI = 0.67–5.56). In adjusted models, PA and IL6 explained 29{\%} and 38{\%}, respectively, of the racial disparity in poor physical performance. Conclusion: Among older women with newly diagnosed non-metastatic breast cancer, poor physical performance was prevalent and AA were disproportionately affected. Less engagement in physical activity and subclinical inflammation partly contributed to this disparity.",
author = "Cynthia Owusu and Mark Schluchter and Koroukian, {Siran M.} and Kathryn Schmitz and Berger, {Nathan A.}",
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Black-white disparity in physical performance among older women with newly diagnosed non-metastatic breast cancer : Exploring the role of inflammation and physical activity. / Owusu, Cynthia; Schluchter, Mark; Koroukian, Siran M.; Schmitz, Kathryn; Berger, Nathan A.

In: Journal of Geriatric Oncology, Vol. 9, No. 6, 01.11.2018, p. 613-619.

Research output: Contribution to journalArticle

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T1 - Black-white disparity in physical performance among older women with newly diagnosed non-metastatic breast cancer

T2 - Exploring the role of inflammation and physical activity

AU - Owusu, Cynthia

AU - Schluchter, Mark

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AU - Schmitz, Kathryn

AU - Berger, Nathan A.

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N2 - Objective: To examine racial differences in physical performance among older women with newly diagnosed non-metastatic breast cancer and identify clinical, behavioral and biological factors that might contribute to such disparities. Methods: This is a cross-sectional study of women aged ≥65 years with newly diagnosed stage I–III breast cancer recruited from ambulatory oncology clinics at an academic center, between September 2010 and August 2015. Participants completed a Comprehensive Geriatric Assessment and laboratory testing for biomarkers of inflammation [interleukin-6 (IL6)] prior to receiving systemic treatment for cancer. The primary outcome was poor physical performance, defined as scoring ≤7 on the Short Physical Performance Battery, Yes or No. Logistic regression analyses were undertaken. Results: Among 135 women with mean age of 74.8 years (SD = 6.9), 31% were African-American (AA), and 33% had poor physical performance. Controlling for age, education, comorbidities and geriatric syndromes, participants with poor physical performance were more likely to be AA [versus (vs.) Non-Hispanic Whites (NHW)], odds ratio (OR) = 3.10, 95% confidence interval (CI) = 1.18–8.15. Controlling further for physical activity (PA) attenuated the racial disparity in physical performance (OR = 2.50, CI = 0.91–6.84). Lastly, controlling for IL6 further diminished the racial disparity in physical performance (OR = 1.93, CI = 0.67–5.56). In adjusted models, PA and IL6 explained 29% and 38%, respectively, of the racial disparity in poor physical performance. Conclusion: Among older women with newly diagnosed non-metastatic breast cancer, poor physical performance was prevalent and AA were disproportionately affected. Less engagement in physical activity and subclinical inflammation partly contributed to this disparity.

AB - Objective: To examine racial differences in physical performance among older women with newly diagnosed non-metastatic breast cancer and identify clinical, behavioral and biological factors that might contribute to such disparities. Methods: This is a cross-sectional study of women aged ≥65 years with newly diagnosed stage I–III breast cancer recruited from ambulatory oncology clinics at an academic center, between September 2010 and August 2015. Participants completed a Comprehensive Geriatric Assessment and laboratory testing for biomarkers of inflammation [interleukin-6 (IL6)] prior to receiving systemic treatment for cancer. The primary outcome was poor physical performance, defined as scoring ≤7 on the Short Physical Performance Battery, Yes or No. Logistic regression analyses were undertaken. Results: Among 135 women with mean age of 74.8 years (SD = 6.9), 31% were African-American (AA), and 33% had poor physical performance. Controlling for age, education, comorbidities and geriatric syndromes, participants with poor physical performance were more likely to be AA [versus (vs.) Non-Hispanic Whites (NHW)], odds ratio (OR) = 3.10, 95% confidence interval (CI) = 1.18–8.15. Controlling further for physical activity (PA) attenuated the racial disparity in physical performance (OR = 2.50, CI = 0.91–6.84). Lastly, controlling for IL6 further diminished the racial disparity in physical performance (OR = 1.93, CI = 0.67–5.56). In adjusted models, PA and IL6 explained 29% and 38%, respectively, of the racial disparity in poor physical performance. Conclusion: Among older women with newly diagnosed non-metastatic breast cancer, poor physical performance was prevalent and AA were disproportionately affected. Less engagement in physical activity and subclinical inflammation partly contributed to this disparity.

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