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• W4247234089 abstract "In their study of 274 elderly Italian cancer patients, Drs. Fratino, Serraino, and Zagonel observed that 15.7% of their sample reported ≥1 limitations in activities of daily living (ADL). Difficulty with dressing was reported most frequently (12.8%). This contrasts with our findings from the Medicare Current Beneficiary Survey in which 48% of elderly patients with self-reported cancer had ≥1 more ADL limitations.1 In our study, walking was the most frequently reported limitation (38%). Despite differences in the prevalence of ADL limitation, the two populations had similar proportions of patients with Instrumental Activity of Daily Living (IADL) limitations. Several differences in study populations and methods of ADL assessment may account for the ADL differences and caution against direct comparison of the two studies. Although our Medicare Current Beneficiary Survey cohort included a randomly sampled, noninstitutionalized elderly population, the impact of possible selection differences for the Italian sample are not clear. For example, patients in the Italian sample may have needed to be sufficiently functional to receive ongoing outpatient care at a regional facility. In addition to language and cultural differences, part of the observed discrepancy also may be due to differences in how ADL limitations were defined. Fratino et al. categorized individuals as functionally limited if they could not independently perform one or more of the following activities: bathing, dressing, going to the toilet, eating, continence, and getting in or out of bed. In our study, individuals were considered limited in an ADL if they responded that they had a lot of difficulty or were unable to do any of the following activities: bathing or showering, dressing, eating, walking, using the toilet, or getting into or out of bed or a chair. The potential impact of population selection and differences in definitions reinforces the value of consistent methods for sampling and survey formulation. Our findings do appear to be consistent with those of Given et al. suggesting that at least 50% of individuals with cancer report limitations with ≥1 ADLs.2 Population and definitional differences may have had a smaller impact on the prevalence of IADL limitations. We are encouraged that research similar to ours is being conducted on the functional limitations of elderly cancer patients. Such research will focus attention on functional status as a vital outcome in the clinical management of cancer. We believe that the end result will be an improvement in cancer care. Randall S. Stafford M.D. Ph.D.*, Philip Cyr M.P.H." @default.
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• W4247234089 doi "https://doi.org/10.1002/(sici)1097-0142(19980801)83:3<590::aid-cncr31>3.0.co;2-p" @default.
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