Diet and exercise intervention helps older, overweight cancer survivors reduce functional decline

Scale with apple and tape measureA home-based diet and exercise program reduced the rate of functional decline among older, overweight long-term survivors of colorectal, breast and prostate cancer, according to a study in the May 13 issue of JAMA.

"In 2008, the Centers for Medicare & Medicaid Services declared mobility maintenance and functional independence among at-risk older individuals as the sole priority in aging research. Older cancer survivors represent an important target because cancer and its treatment are associated with accelerated functional decline," the authors write. The practice of healthy lifestyle behaviors may reduce risk for disease and functional decline. However, many older cancer survivors report poor lifestyle behaviors, and few meet recommended health promotion guidelines. "Lifestyle interventions may provide benefit, but it is unknown whether long-term cancer survivors can modify their lifestyle behaviors sufficiently to improve functional status."

Miriam C. Morey, Ph.D., of Duke University, Durham, N.C., and colleagues conducted a randomized, controlled trial that tested a home-based diet and exercise intervention and its effect on functional decline among 641 older (age 65-91 years), overweight (BMI 25 or greater and less than 40) long-term (5 years or greater) survivors of breast, prostate, and colorectal cancer. The participants were randomly assigned to an intervention group (n = 319) or delayed intervention (control) group (n = 322) in Canada, the United Kingdom, and the United States. The 12-month intervention consisted of a home-based program of telephone counseling and mailed materials promoting exercise, improved diet quality, and modest weight loss. Change in functional status was assessed using the physical function subscale of the Medical Outcomes Study Short-Form 36 (SF-36) questionnaire (score range, 0-100; a high score indicates better functioning). Other outcomes included changes in function on the basic and advanced lower-extremity function (i.e., use of legs) subscales of the Late Life Function and Disability Index (score range, 0-100), physical activity, body mass index and overall health-related quality of life.

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