{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T17:09:57Z","timestamp":1778519397621,"version":"3.51.4"},"reference-count":40,"publisher":"Human Kinetics","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,4,1]]},"abstract":"<jats:p><jats:italic><jats:bold>Purpose<\/jats:bold>:<\/jats:italic> (a)\u00a0To describe the relationship of multimorbidity and physical activity (PA) in cancer survivors and (b)\u00a0to explore perceived disability and PA in middle-aged and older survivors. <jats:italic><jats:bold>Methods<\/jats:bold>:<\/jats:italic> The authors analyzed the data from cancer survivors (<jats:italic>N<\/jats:italic>\u2009=\u2009566), identified using the Pennsylvania Cancer Registry, who responded to a Behavioral Risk Factor Surveillance System-derived questionnaire. They created age groups (e.g.,\u00a045\u201354 years, 55\u201364 years, 65\u201374 years, and 75 years and older) and calculated a composite score of eight common comorbidities (e.g.,\u00a0chronic obstructive pulmonary disease, heart disease) to assess multimorbidity. Logistic regression was used to estimate the association of demographic and behavioral\/clinical risk factors (e.g.,\u00a0multimorbidity, perceived disability, body mass index) with PA. <jats:italic><jats:bold>Results<\/jats:bold>:<\/jats:italic> Most respondents were females (62%), older (mean age\u2009=\u200968 years) and represented diverse cancer sites, including breast (<jats:italic>n<\/jats:italic>\u2009=\u2009132), colorectal (<jats:italic>n<\/jats:italic>\u2009=\u2009102), gynecologic (<jats:italic>n<\/jats:italic>\u2009=\u2009106), prostate (<jats:italic>n<\/jats:italic>\u2009=\u2009111), and lung (<jats:italic>n<\/jats:italic>\u2009=\u200980). PA participation was mixed; 44% of survivors reported achieving &gt;150\u00a0min of aerobic PA, but half of lung and 37% of gynecologic survivors reported no PA (0\u00a0min\/week). Higher multimorbidity (odds ratio\u2009=\u20090.82, confidence\u00a0 interval [0.69, 0.98], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), obesity (odds ratio\u2009=\u20090.51, confidence\u00a0 interval [0.30, 0.86], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.05), and perceived disability (odds ratio\u2009=\u20090.49, confidence\u00a0 interval [0.32, 0.77], <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) were negatively associated with PA participation. Strength training was suboptimal across all survivors. <jats:italic><jats:bold>Conclusion<\/jats:bold>:<\/jats:italic> Most older survivors experienced comorbid conditions, and this was associated with less PA. Survivors who perceived themselves as disabled or who were obese were half as likely as others to participate in PA. This suggests an increasing need to address both physical and psychological limitations in designing PA interventions for real-world needs. Exercise interventions that address the unique needs of older survivors for multimorbidity, obesity, and perceived disability may strengthen opportunities for PA.<\/jats:p>","DOI":"10.1123\/japa.2019-0086","type":"journal-article","created":{"date-parts":[[2019,11,6]],"date-time":"2019-11-06T06:54:24Z","timestamp":1573023264000},"page":"311-319","source":"Crossref","is-referenced-by-count":15,"title":["Physical Activity in Older Cancer Survivors: What Role Do Multimorbidity and Perceived Disability Play?"],"prefix":"10.1123","volume":"28","author":[{"given":"Shirley M.","family":"Bluethmann","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wayne","family":"Foo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renate M.","family":"Winkels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scherezade K.","family":"Mama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn H.","family":"Schmitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"100","reference":[{"key":"ref231","doi-asserted-by":"crossref","first-page":"81","DOI":"10.17925\/OHR.2012.08.2.81","article-title":"Exercise recommendations for cancer-related fatigue, cognitive impairment, sleep problems, depression, pain, anxiety, and physical dysfunction: A review","volume":"8","author":"Mustian","year":"2012","journal-title":"Oncology & Hematology Review,"},{"key":"ref321","first-page":"CD003817","article-title":"Exercise for overweight or obesity","author":"Shaw","year":"2006","journal-title":"Cochrane Database of Systematic Reviews,"},{"key":"ref281","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1186\/1471-2288-13-49","article-title":"A systematic review of publications assessing reliability and validity of the behavioral risk factor surveillance system (BRFSS), 2004\u20132011","volume":"13","author":"Pierannunzi","year":"2013","journal-title":"BMC Medical Research Methodology,"},{"key":"ref341","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s11764-014-0413-z","article-title":"A systematic review and meta-analysis of social cognitive theory-based physical activity and\/or nutrition behavior change interventions for cancer survivors","volume":"9","author":"Stacey","year":"2015","journal-title":"Journal of Cancer Survivorship,"},{"key":"ref31","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/S0749-3797(03)00182-X","article-title":"Promoting physical activity for older adults: The challenges for changing behavior","volume":"25","author":"Brawley","year":"2003","journal-title":"American Journal of Preventive Medicine,"},{"key":"ref101","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1177\/0898264317707299","article-title":"Functional status and adaptation: Measuring activities of daily living and device use in the national health and aging trends study","volume":"30","author":"Frochen","year":"2018","journal-title":"Journal of Aging and Health,"},{"key":"ref381","doi-asserted-by":"crossref","first-page":"2595","DOI":"10.1200\/JCO.2013.54.8347","article-title":"International society of geriatric oncology consensus on geriatric assessment in older patients with cancer","volume":"32","author":"Wildiers","year":"2014","journal-title":"Journal of Clinical Oncology,"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1093\/epirev\/mxs009","article-title":"Multimorbidity in older adults","volume":"35","author":"Salive","year":"2013","journal-title":"Epidemiologic Reviews,"},{"key":"ref391","doi-asserted-by":"crossref","first-page":"822","DOI":"10.1016\/j.jada.2007.02.017","article-title":"Nutrition assessment in the National Health and Nutrition Examination Survey 1999\u20132002","volume":"107","author":"Wright","year":"2007","journal-title":"Journal of the American Dietetic Association,"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1249\/01.mss.0000536313.40909.f6","article-title":"Rural-urban differences in meeting physical activity recommendations in cancer survivors in central Pennsylvania: 1549 board# 1 may 31 1","volume":"50","author":"Mama","year":"2018","journal-title":"Medicine & Science in Sports & Exercise,"},{"key":"ref81","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.jamda.2011.01.003","article-title":"Sarcopenia: An undiagnosed condition in older adults. Current consensus definition: Prevalence, etiology, and consequences. International working group on sarcopenia","volume":"12","author":"Fielding","year":"2011","journal-title":"Journal of the American Medical Directors Association,"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1007\/s11764-011-0204-8","article-title":"Comparison of physical activity levels between cancer survivors and non-cancer participants in the 2009 BRFSS","volume":"6","author":"Kwon","year":"2012","journal-title":"Journal of Cancer Survivorship,"},{"key":"ref201","doi-asserted-by":"crossref","first-page":"3568","DOI":"10.1200\/JCO.2014.58.4680","article-title":"American Society of Clinical Oncology position statement on obesity and cancer","volume":"32","author":"Ligibel","year":"2014","journal-title":"Journal of Clinical Oncology,"},{"key":"ref21","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1177\/1559827618755681","article-title":"Healthy living after cancer treatment: Considerations for clinical and community practice","volume":"12","author":"Bluethmann","year":"2018","journal-title":"American Journal of Lifestyle Medicine,"},{"key":"ref331","doi-asserted-by":"crossref","DOI":"10.1016\/j.jgo.2019.05.007","article-title":"Healthcare providers\u2019 discussions of physical activity with older survivors of cancer: Potential missed opportunities for health promotion","author":"Siembida","year":"2019","journal-title":"Journal of Geriatric Oncology"},{"key":"ref01","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/j.1365-2354.2008.00975.x","article-title":"Health-related quality of life in elderly cancer patients, elderly non-cancer patients and an elderly general population","volume":"18","author":"Baumann","year":"2009","journal-title":"European Journal of Cancer Care,"},{"key":"ref291","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1111\/jgs.13524","article-title":"Body mass index trajectories in relation to change in lean mass and physical function: The health, aging and body composition study","volume":"63","author":"Reinders","year":"2015","journal-title":"Journal of the American Geriatrics Society,"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1161\/CIRCULATIONAHA.107.185650","article-title":"Physical activity and public health in older adults: Recommendation from the American College of Sports Medicine and the American Heart Association","volume":"116","author":"Nelson","year":"2007","journal-title":"Circulation,"},{"key":"ref401","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1016\/j.numecd.2007.10.002","article-title":"Sarcopenic obesity: A new category of obesity in the elderly","volume":"18","author":"Zamboni","year":"2008","journal-title":"Nutrition, Metabolism and Cardiovascular Diseases,"},{"key":"ref151","doi-asserted-by":"crossref","first-page":"1932","DOI":"10.1161\/CIR.0000000000000203","article-title":"The national physical activity plan: A call to action from the American Heart Association: A science advisory from the American Heart Association","volume":"131,","author":"Kraus","year":"2015","journal-title":"Circulation,"},{"key":"ref261","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.amepre.2004.12.002","article-title":"Behavioral determinants of healthy aging","volume":"28","author":"Peel","year":"2005","journal-title":"American Journal of Preventive Medicine,"},{"key":"ref141","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1093\/poq\/nfh006","article-title":"A comparison of web and mail survey response rates","volume":"68","author":"Kaplowitz","year":"2004","journal-title":"Public Opinion Quarterly,"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"75","DOI":"10.3122\/jabfm.2011.01.100076","article-title":"Obesity and women\u2019s health: An evidence-based review","volume":"24","author":"Kulie","year":"2011","journal-title":"Journal of the American Board of Family Medicine,"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"411","DOI":"10.21037\/gs.2018.07.05","article-title":"Osteoporosis and musculoskeletal complications related to therapy of breast cancer","volume":"7","author":"Suskin","year":"2018","journal-title":"Gland Surgery,"},{"key":"ref221","volume-title":"Integrative analytic methods using population-level cross-sectional data","author":"Moser","year":"2013"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1158\/1055-9965.EPI-10-0988","article-title":"Efficacy of exercise interventions in modulating cancer-related fatigue among adult cancer survivors: A meta-analysis","volume":"20","author":"Brown","year":"2011","journal-title":"Cancer Epidemiology, Biomarkers & Prevention,"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"1334","DOI":"10.1249\/MSS.0b013e318213fefb","article-title":"American college of sports medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: Guidance for prescribing exercise","volume":"43","author":"Garber","year":"2011","journal-title":"Medicine & Science in Sports & Exercise,"},{"key":"ref251","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1093\/annonc\/mdt037","article-title":"Aromatase inhibitor-induced arthralgia: A review","volume":"24","author":"Niravath","year":"2013","journal-title":"Annals of Oncology,"},{"key":"ref171","first-page":"254","article-title":"American Cancer Society guidelines on nutrition and physical activity for cancer prevention: Reducing the risk of cancer with healthy food choices and physical activity","volume":"56","author":"Kushi","year":"2006","journal-title":"CA: A Cancer Journal for Clinicians,"},{"key":"ref191","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1891\/0198-8794.36.205","article-title":"Resistance exercise to prevent and manage sarcopenia and dynapenia","volume":"36","author":"Law","year":"2016","journal-title":"Annual Review of Gerontology and Geriatrics,"},{"key":"ref121","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1093\/ageing\/afv001","article-title":"The role of perceived barriers and objectively measured physical activity in adults aged 65\u2013100","volume":"44","author":"Gellert","year":"2015","journal-title":"Age and Ageing,"},{"key":"ref351","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1037\/a0037875","article-title":"Life after diagnosis and treatment of cancer in adulthood: Contributions from psychosocial oncology research","volume":"70","author":"Stanton","year":"2015","journal-title":"American Psychologist,"},{"key":"ref301","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1682\/JRRD.2007.02.0042","article-title":"Barriers associated with exercise and community access for individuals with stroke","volume":"45","author":"Rimmer","year":"2008","journal-title":"Journal of Rehabilitation Research & Development,"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1158\/1055-9965.EPI-16-0133","article-title":"Anticipating the \u201cSilver tsunami\u201d: Prevalence trajectories and comorbidity burden among older cancer survivors in the United States","volume":"25","author":"Bluethmann","year":"2016","journal-title":"Cancer Epidemiology, Biomarkers & Prevention,"},{"key":"ref131","volume-title":"ACSM\u2019s Exercise is Medicine\u2122: A clinician\u2019s guide to exercise prescription","author":"Jonas","year":"2012"},{"key":"ref91","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1370\/afm.272","article-title":"Prevalence of multimorbidity among adults seen in family practice","volume":"3","author":"Fortin","year":"2005","journal-title":"Annals of Family Medicine,"},{"key":"ref71","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.jamda.2015.03.013","article-title":"Aging and multimorbidity: New tasks, priorities, and frontiers for integrated gerontological and clinical research","volume":"16","author":"Fabbri","year":"2015","journal-title":"Journal of the American Medical Directors Association,"},{"key":"ref51","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1373\/clinchem.2017.277376","article-title":"Obesity and cancer: Evidence, impact, and future directions","volume":"64","author":"Colditz","year":"2018","journal-title":"Clinical Chemistry,"},{"key":"ref271","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/gerona\/gln001","article-title":"Physical activity as a preventative factor for frailty: The health, aging, and body composition study","volume":"64","author":"Peterson","year":"2009","journal-title":"The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences,"},{"key":"ref61","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1097\/MLR.0000000000000166","article-title":"Multiple chronic conditions and life expectancy: A life table analysis","volume":"52","author":"DuGoff","year":"2014","journal-title":"Medical Care,"}],"container-title":["Journal of Aging and Physical Activity"],"original-title":[],"link":[{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/japa\/28\/2\/article-p311.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.humankinetics.com\/downloadpdf\/journals\/japa\/28\/2\/article-p311.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T21:04:04Z","timestamp":1652994244000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.humankinetics.com\/view\/journals\/japa\/28\/2\/article-p311.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,1]]},"references-count":40,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.1123\/japa.2019-0086","relation":{},"ISSN":["1063-8652","1543-267X"],"issn-type":[{"value":"1063-8652","type":"print"},{"value":"1543-267X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,1]]}}}