The Association of Neighborhood Characteristics and Frailty in Childhood Cancer Survivors: A Report from the St. Jude Lifetime Cohort Study.

Autor:	Schwartz LF; University of Chicago Comer Children's Hospital, Chicago, Illinois., Dhaduk R; St. Jude Children's Research Hospital, Memphis, Tennessee., Howell CR; The University of Alabama at Birmingham, Birmingham, Alabama., Brinkman TM; St. Jude Children's Research Hospital, Memphis, Tennessee., Ehrhardt MJ; St. Jude Children's Research Hospital, Memphis, Tennessee., Delaney A; St. Jude Children's Research Hospital, Memphis, Tennessee., Srivastava DK; St. Jude Children's Research Hospital, Memphis, Tennessee., Lanctot JQ; St. Jude Children's Research Hospital, Memphis, Tennessee., Armstrong GT; St. Jude Children's Research Hospital, Memphis, Tennessee., Robison LL; St. Jude Children's Research Hospital, Memphis, Tennessee., Hudson MM; St. Jude Children's Research Hospital, Memphis, Tennessee., Ness KK; St. Jude Children's Research Hospital, Memphis, Tennessee., Henderson TO; University of Chicago Comer Children's Hospital, Chicago, Illinois.
Jazyk:	angličtina
Zdroj:	Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2023 Aug 01; Vol. 32 (8), pp. 1021-1029.
DOI:	10.1158/1055-9965.EPI-22-1322
Abstrakt:	Background: Childhood cancer survivors experience reduced physiologic reserve, or frailty, earlier and more frequently than peers. In other populations, frailty is impacted by one's neighborhood. This study's purpose was to evaluate associations between neighborhood characteristics and frailty in childhood cancer survivors. Methods: Participants in the St. Jude Lifetime Cohort Study with geocoded residential addresses were analyzed. Pre-frailty/Frailty was defined as having 1-2/≥3 of sarcopenia, muscle weakness, poor endurance, slow walking speed, and exhaustion from direct assessments. Neighborhood characteristics [e.g., access to exercise opportunities and healthy food, neighborhood socioeconomic status (nSES), and rurality/urbanicity] were determined using publicly available geospatial data. Nested multivariable logistic regression models identified associations between neighborhood characteristics and pre-frailty/frailty, adjusting for chronic health conditions, individual health behaviors and socio-demographics, and high-risk cancer treatment exposures. Results: For our cohort (N = 3,806, 46.79% female, 81.40% white, mean age 33.63±9.91 years), compared with non-frail survivors (n = 2,573; 67.6%), pre-frail (n = 900; 23.6%) and frail survivors (n = 333; 8.7%) were more likely to live in neighborhoods with decreased exercise opportunities (frail OR: 1.62, 1.26-2.09), reduced healthy food access (pre-frail OR: 1.28, 1.08-1.51; frail OR: 1.36, 1.06-1.75), and lower nSES (pre-frail OR: 1.31, 1.12-1.52; frail OR: 1.64, 1.30-2.07). Participants had 8% increased odds (95% confidence interval, 2%-14%) of being pre-frail/frail if they lived in "resource poor" neighborhoods as opposed to "resource rich" neighborhoods after adjusting for other pre-frailty/frailty risk factors. Conclusions: The neighborhood a childhood cancer survivor resides in as an adult is associated with pre-frailty/frailty. Impact: This study provides valuable information for creating interventions using neighborhood-level factors to mitigate frailty and improve health outcomes in survivors. See related commentary by Bhandari and Armenian, p. 997. (©2023 American Association for Cancer Research.)
Databáze:	MEDLINE
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