Physical resilience of older cancer survivors: An emerging concept

Objectives: To characterize factors contributing to physical resilience in older cancer survivors, as demonstrated by resistance to decline or recovery (resilience). Materials and Methods: We conducted a secondary analysis of data from a randomized controlled trial of cancer survivors ≥ 65 years old and ≥ 5 years from cancer diagnoses. Physical function was assessed quarterly over 2 years, with Short-Form 36 physical function subscale. Participants with ≥ 2 follow-up assessments (n = 594) were evaluated for physical resilience: 1) Resistance was defined as lack of any decline, where decline was a drop of ≥ 13 points, and 2) resilience (i.e., recovery) was defined as regaining ≥ 50% of lost function, subsequent to decline. Results: Mean age was 73.1 years and 89.1% were Caucasian. Forty-nine percent (n = 289) were resistant to decline in function; these individuals were younger, had higher education and income, were more likely to be Caucasian, and had higher baseline physical function (mean difference [MD] 7.8 points, 95% CI 5.0–10.8) and general health (MD 7.5 points, 95% CI 4.9–10.1). Fifty-seven percent (n = 137 of 239) demonstrated resilience, with 91.2% (n = 125) recovering within 6 months of declines; these participants had higher baseline physical function (MD 6.6 points, 95% CI 1.8–11.4), but similar pre-decline function. More participants who were resistant, and more who showed resilience, reported high self-efficacy and social support. Conclusions: The majority of older cancer survivors exhibited physical resilience; this was associated with high baseline health, physical function, self-efficacy, and social support. Assessing and targeting psychosocial factors may be important for interventions seeking to promote physical resilience. © 2016