Falls and Frailty in Prostate Cancer Survivors: Current, Past, and Never Users of Androgen Deprivation Therapy

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="section-title" id="d9478535e195">BACKGROUND/OBJECTIVES</h5> <p id="P1">In prostate cancer survivors (PCS), androgen deprivation therapy (ADT) causes muscle loss, weakness, and fatigue, that may not reverse with cessation of treatment and that could increase the risk of falls and frailty. We compared the prevalence of and association between falls and frailty among PCS who were current, past or never users of ADT. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="section-title" id="d9478535e200">DESIGN</h5> <p id="P2">Cross-sectional study</p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="section-title" id="d9478535e205">SETTING</h5> <p id="P3">Mail and electronic survey</p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="section-title" id="d9478535e210">PARTICIPANTS</h5> <p id="P4">PCS (N=280; mean age: 72±8 years)</p> </div><div class="section"> <a class="named-anchor" id="S5"> <!-- named anchor --> </a> <h5 class="section-title" id="d9478535e215">MEASUREMENTS</h5> <p id="P5">Cancer history, falls and frailty status (robust, pre-frail or frail) using traditional and obese phenotypes. </p> </div><div class="section"> <a class="named-anchor" id="S6"> <!-- named anchor --> </a> <h5 class="section-title" id="d9478535e220">RESULTS</h5> <p id="P6">Current (37%) or past (34%) ADT users were more than twice as likely to have fallen in the previous year compared never users (15%) (p=0.002). ADT users had twice as many recurrent falls (p &lt;0.001) and more fall-related injuries than unexposed men (p=0.01). Current (43%) or past (40%) ADT users were more likely to be classified as pre-frail or frail than never users (15%) (p&lt;0.001), and the prevalence of obese pre-frailty + frailty was even greater among current (59%) or past (62%) ADT users compared to never users (25%) (p&lt;0.001). Traditional and obese frailty significantly increased the likelihood of reporting falls in the previous year (OR: 2.15; 95% CI: 1.18, 3.94 and OR: 2.97; 95% CI: 1.62, 5.58, respectively) and was also associated with increased risk of recurrent falls (OR: 3.10; 95% CI: 1.48, 6.5 and OR: 3.99; 95% CI: 1.79, 8.89, respectively). </p> </div><div class="section"> <a class="named-anchor" id="S7"> <!-- named anchor --> </a> <h5 class="section-title" id="d9478535e225">CONCLUSIONS</h5> <p id="P7">Current, as well as past exposure to ADT is linked to a higher risk of falls and frailty compared to no treatment. Prostate cancer survivors should be appropriately counseled on fall prevention strategies while approaches to reduce the frailty phenotype should be considered. </p> </div>