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Original Research
Complex multimorbidity and health outcomes in older adult cancer survivors
  1. David F. Warner1,
  2. Nicholas K. Schiltz2,
  3. Kurt C. Stange3,6,
  4. Charles W. Given4,
  5. Cynthia Owusu5,6,
  6. Nathan A. Berger5,6 and
  7. Siran M. Koroukian2,6
  1. 1. Department of Sociology, 711 Oldfather Hall, University of Nebraska–Lincoln, 1400 R St., Lincoln, NE 68588, USA
  2. 2. Department of Epidemiology and Biostatistics, School of Medicine, Wood Building, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
  3. 3. Department of Family Medicine and Community Health, Bolwell Building, School of Medicine, Case Western Reserve University, 11000 Euclid Ave., Cleveland, OH 44106, USA
  4. 4. Department of Family Medicine, Clinical Center, Michigan State University, 788 Service Rd., East Lansing, MI 48824, USA
  5. 5. Division of Hematology/Oncology, Department of Medicine, School of Medicine, Wolstein Building, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106, USA
  6. 6. Case Comprehensive Cancer Center, Wearn Building, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH 44106, USA
  1. Corresponding Author: Associate Professor, Department of Sociology, 711 Oldfather Hall, University of Nebraska-Lincoln, 1400 R St., Lincoln, NE 68588, USA Tel.: +1-402-4723421 E-mail: dwarner3{at}unl.edu

Abstract

Objective To characterize complex multimorbidity among cancer survivors and evaluate the association between cancer survivorship, time since cancer diagnosis, and self-reported fair/poor health, self-rated worse health in 2 years, and 2-year mortality.

Methods We used the 2010–2012 Health and Retirement Study. Cancer survivors were individuals who reported a (nonskin) cancer diagnosis 2 years or more before the interview. We defined complex multimorbidity as the co-occurrence of chronic conditions, functional limitations, and/or geriatric syndromes. In addition to descriptive analyses, we used logistic regression to evaluate the independent association between cancer survivor status and health outcomes. We also examined whether cancer survivorship differed by the number of years since diagnosis.

Results Among 15,808 older adults (age ≥50 years), 11.8% were cancer survivors. Compared with cancer-free individuals, a greater percentage of cancer survivors had complex multimorbidity: co-occurring chronic conditions, functional limitations, and geriatric syndromes. Cancer survivorship was significantly associated with self-reported fair/poor health, self-rated worse health in 2 years, and 2-year mortality. These effects declined with the number of years since diagnosis for fair/poor health and mortality but not for self-rated worse health.

Conclusion Cancer survivor status is independently associated with more complex multimorbidity, and with worse health outcomes. These effects attenuate with time, except for patient perception of being in worse health.

  • Comorbidity
  • functional limitations
  • geriatric syndromes
  • multimorbidity
  • health status
  • health decline
  • mortality, cancer survivorship

This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 Unported License (CC BY-NC 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.15212/FMCH.2017.0127

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