Association of time-varying rest-activity rhythm with survival in older adults with lung cancer

Research output: Contribution to journalArticle

Abstract

BACKGROUND: To the best of our knowledge, this is the first study to examine the relationship of rest-activity rhythm with survival in older adults with lung cancer and to consider variations in rest-activity rhythm over time.

OBJECTIVE: The aim of this study was to explore the relationship between rest-activity rhythm variations and survival in 33 older adults with lung cancer by considering rest-activity rhythm as a time-dependent covariate over time.

METHODS: In this prospective study with 5 repeated measurements, patients' rest-activity rhythm over 3 days was measured using actigraphy. The rest-activity rhythm was represented using the dichotomy index I (in-bed activity) < O (out-of-bed activity). The median I < O was used as the cutoff point, with an I < O of greater than or equal to 85.59% and less than 85.59% indicating robust and disrupted rest-activity rhythms, respectively. Data were analyzed using the Cox regression model with time-dependent repeated measurements of a covariate.

RESULTS: In the time-dependent multivariate Cox model, a disrupted rest-activity rhythm was independently associated with a higher risk of death than was a robust rest-activity rhythm (hazard ratio, 16.05; P=.009).

CONCLUSION: A time-varying rest-activity rhythm is incrementally associated with mortality in older adults with lung cancer and represents a rigorous and independent prognostic factor for their survival.

IMPLICATIONS FOR PRACTICE: Clinicians may need to pay more attention to the rest-activity rhythms of older adults with lung cancer during disease progression. Future studies should account for the variation in rest-activity rhythm over time.

Original languageEnglish
Article number7
JournalCancer Nursing
DOIs
Publication statusE-pub ahead of print - Oct 5 2018

Fingerprint

Lung Neoplasms
Survival
Proportional Hazards Models
Actigraphy
Disease Progression
Prospective Studies
Mortality

Keywords

  • Lung cancer
  • Older adults
  • Rest-activity rhythm
  • Survival
  • Time-dependent Cox model

Cite this

@article{9248e8d728ce49e1a07c29a365906ddc,
title = "Association of time-varying rest-activity rhythm with survival in older adults with lung cancer",
abstract = "BACKGROUND: To the best of our knowledge, this is the first study to examine the relationship of rest-activity rhythm with survival in older adults with lung cancer and to consider variations in rest-activity rhythm over time.OBJECTIVE: The aim of this study was to explore the relationship between rest-activity rhythm variations and survival in 33 older adults with lung cancer by considering rest-activity rhythm as a time-dependent covariate over time.METHODS: In this prospective study with 5 repeated measurements, patients' rest-activity rhythm over 3 days was measured using actigraphy. The rest-activity rhythm was represented using the dichotomy index I (in-bed activity) < O (out-of-bed activity). The median I < O was used as the cutoff point, with an I < O of greater than or equal to 85.59{\%} and less than 85.59{\%} indicating robust and disrupted rest-activity rhythms, respectively. Data were analyzed using the Cox regression model with time-dependent repeated measurements of a covariate.RESULTS: In the time-dependent multivariate Cox model, a disrupted rest-activity rhythm was independently associated with a higher risk of death than was a robust rest-activity rhythm (hazard ratio, 16.05; P=.009).CONCLUSION: A time-varying rest-activity rhythm is incrementally associated with mortality in older adults with lung cancer and represents a rigorous and independent prognostic factor for their survival.IMPLICATIONS FOR PRACTICE: Clinicians may need to pay more attention to the rest-activity rhythms of older adults with lung cancer during disease progression. Future studies should account for the variation in rest-activity rhythm over time.",
keywords = "Lung cancer, Older adults, Rest-activity rhythm, Survival, Time-dependent Cox model, Lung cancer, Older adults, Rest-activity rhythm, Survival, Time-dependent Cox model",
author = "Lou-Ching Kuo and Wen-Pei Chang and Hui-Chuan Huang and Chia-Chin Lin",
year = "2018",
month = "10",
day = "5",
doi = "10.1097/NCC.0000000000000647",
language = "English",
journal = "Cancer Nursing",
issn = "0162-220X",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Association of time-varying rest-activity rhythm with survival in older adults with lung cancer

AU - Kuo, Lou-Ching

AU - Chang, Wen-Pei

AU - Huang, Hui-Chuan

AU - Lin, Chia-Chin

PY - 2018/10/5

Y1 - 2018/10/5

N2 - BACKGROUND: To the best of our knowledge, this is the first study to examine the relationship of rest-activity rhythm with survival in older adults with lung cancer and to consider variations in rest-activity rhythm over time.OBJECTIVE: The aim of this study was to explore the relationship between rest-activity rhythm variations and survival in 33 older adults with lung cancer by considering rest-activity rhythm as a time-dependent covariate over time.METHODS: In this prospective study with 5 repeated measurements, patients' rest-activity rhythm over 3 days was measured using actigraphy. The rest-activity rhythm was represented using the dichotomy index I (in-bed activity) < O (out-of-bed activity). The median I < O was used as the cutoff point, with an I < O of greater than or equal to 85.59% and less than 85.59% indicating robust and disrupted rest-activity rhythms, respectively. Data were analyzed using the Cox regression model with time-dependent repeated measurements of a covariate.RESULTS: In the time-dependent multivariate Cox model, a disrupted rest-activity rhythm was independently associated with a higher risk of death than was a robust rest-activity rhythm (hazard ratio, 16.05; P=.009).CONCLUSION: A time-varying rest-activity rhythm is incrementally associated with mortality in older adults with lung cancer and represents a rigorous and independent prognostic factor for their survival.IMPLICATIONS FOR PRACTICE: Clinicians may need to pay more attention to the rest-activity rhythms of older adults with lung cancer during disease progression. Future studies should account for the variation in rest-activity rhythm over time.

AB - BACKGROUND: To the best of our knowledge, this is the first study to examine the relationship of rest-activity rhythm with survival in older adults with lung cancer and to consider variations in rest-activity rhythm over time.OBJECTIVE: The aim of this study was to explore the relationship between rest-activity rhythm variations and survival in 33 older adults with lung cancer by considering rest-activity rhythm as a time-dependent covariate over time.METHODS: In this prospective study with 5 repeated measurements, patients' rest-activity rhythm over 3 days was measured using actigraphy. The rest-activity rhythm was represented using the dichotomy index I (in-bed activity) < O (out-of-bed activity). The median I < O was used as the cutoff point, with an I < O of greater than or equal to 85.59% and less than 85.59% indicating robust and disrupted rest-activity rhythms, respectively. Data were analyzed using the Cox regression model with time-dependent repeated measurements of a covariate.RESULTS: In the time-dependent multivariate Cox model, a disrupted rest-activity rhythm was independently associated with a higher risk of death than was a robust rest-activity rhythm (hazard ratio, 16.05; P=.009).CONCLUSION: A time-varying rest-activity rhythm is incrementally associated with mortality in older adults with lung cancer and represents a rigorous and independent prognostic factor for their survival.IMPLICATIONS FOR PRACTICE: Clinicians may need to pay more attention to the rest-activity rhythms of older adults with lung cancer during disease progression. Future studies should account for the variation in rest-activity rhythm over time.

KW - Lung cancer

KW - Older adults

KW - Rest-activity rhythm

KW - Survival

KW - Time-dependent Cox model

KW - Lung cancer

KW - Older adults

KW - Rest-activity rhythm

KW - Survival

KW - Time-dependent Cox model

U2 - 10.1097/NCC.0000000000000647

DO - 10.1097/NCC.0000000000000647

M3 - Article

JO - Cancer Nursing

JF - Cancer Nursing

SN - 0162-220X

M1 - 7

ER -