Functional Limitations in Cancer Survivors among Elderly Medicare Beneficiaries

The ability to perform daily activities independently is a crucial component of quality of life among elderly people. We used Medicare Current Beneficiary Survey (MCBS) data from 2006 to 2009 to evaluate whether functional status decreased significantly in cancer patients who had survived for one or more years compared to patients without cancer. The MCBS is a longitudinal survey of the entire Medicare beneficiaries, conducted three times a year over a 3 year period to track health status changes and health care use. Personal, social, and physical functional limitation questions were asked during each Fall round of survey. Analysis included 5,362 (17.4%) cancer survivors and 25,461 (82.6%) non-cancer beneficiaries. Design-based logistic models with survey weights were used.15.9% of cancer survivors had any functional limitations vs. 13.3% in non-cancer survivors (p <0.001). While physical limitations (especially difficulty stooping, 33.7% in cancer survivors) were the most common between cancer survivors and non-cancer beneficiaries (26.6% vs. 22.5%), personal (15.5% vs. 12.7%) and social limitations (12.8% vs. 10.5%) were also significant (all p<0.001). After adjusting for socio-demographic characteristics and comorbidities like heart disease, stroke, paralysis, and arthritis, the odds ratio comparing cancer survivors with non-cancer beneficiaries was 1.11 (95% confidence interval, (CI): 1.01-1.23) for physical limitations, 1.14 (CI: 1.01-1.28) for personal limitations, and 1.16 (CI: 1.03-1.30) for social limitations.  However, these differences decreased over the follow-up year (p=0.01). Therefore, healthcare professionals should heed to the competing demands in health needs among elderly cancer survivors and proactively facilitate their daily functional independence.