{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T23:26:01Z","timestamp":1792279561722,"version":"4.4.0"},"reference-count":35,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Functional limitations are common among older cancer survivors and tend to increase with age and survivorship duration. Physical activity (PA) associates with better functional outcomes, but little is known about how these associations vary as time passes post-diagnosis. This study examined how years since diagnosis, three types of physical activity, and their interactions associate with functional limitations in older cancer survivors. Methods: Data drawn from the 2021 National Health Interview Survey (NHIS), representing adults aged 55+ and with a prior cancer diagnosis (n = 9356; mean age = 72.17 \u00b1 8.5 years), were studied. A four-item self-reported difficulty index (i.e., washing\/dressing, walking one block, climbing stairs, and picking up\/opening objects) was summed to measure functional limitations. PA was assessed using the items aligned with the United States PA Guidelines. Hierarchical regression was used to evaluate associations between functional limitations and years since diagnosis, vigorous physical activity, moderate physical activity, and strength training. Interaction effects of years since diagnosis and each activity type were also examined. Covariates were age, sex, BMI, and educational attainment. Results: Elapsed time since cancer diagnosis positively associated with functional limitations in interaction with physical behaviors, while moderate physical activity and strength training negatively associated with functional limitations. Interactions of years since diagnosis and both moderate physical activity and strength training revealed smaller increases in functional limitations. No interaction effects were observed for vigorous physical activity. Conclusions: Among older cancer survivors, the association between survivorship duration and functional limitations differs by engagement in moderate and resistance-based physical activity. These findings support the clinical importance of promoting sustainable, non-vigorous physical activity in long-term survivorship care.<\/jats:p>","DOI":"10.3390\/jcm15020856","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T08:48:08Z","timestamp":1768985288000},"page":"856","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Older Adult Cancer Survivors\u2019 Functional Limitations and Determinants of Health: Evidence from the 2021 National Health Interview Survey"],"prefix":"10.3390","volume":"15","author":[{"given":"Anna Kate","family":"Autry","sequence":"first","affiliation":[{"name":"Webb School of Knoxville, Knoxville, TN 37928, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zarmina","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee-Knoxville, 328 HPER Building, 1914 Andy Holt Avenue, Knoxville, TN 37928, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6037-0439","authenticated-orcid":false,"given":"Zan","family":"Gao","sequence":"additional","affiliation":[{"name":"Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee-Knoxville, 328 HPER Building, 1914 Andy Holt Avenue, Knoxville, TN 37928, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref_1","unstructured":"American Cancer Society (2025). Cancer Treatment & Survivorship Facts & Figures 2022\u20132024, American Cancer Society."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"pkaf084","DOI":"10.1093\/jncics\/pkaf084","article-title":"Physical activity and mobility disability in older adult cancer survivors","volume":"9","author":"Brown","year":"2025","journal-title":"JNCI Cancer Spectr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1540","DOI":"10.1002\/cncr.29211","article-title":"Frailty in childhood cancer survivors","volume":"121","author":"Ness","year":"2015","journal-title":"Cancer"},{"key":"ref_4","first-page":"43","article-title":"Physical functioning and rehabilitation in cancer survivors","volume":"64","author":"Stubblefield","year":"2014","journal-title":"CA Cancer J. Clin."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Alwhaibi, M., Al-Ruthia, Y., and Sales, I. (2023). The impact of depression and anxiety on adult cancer patients\u2019 health-related quality of life. J. Clin. Med., 12.","DOI":"10.3390\/jcm12062196"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Misi\u0105g, W., Piszczyk, A., Szyma\u0144ska-Chabowska, A., and Chabowski, M. (2022). Physical activity and cancer care\u2014A review. Cancers, 14.","DOI":"10.3390\/cancers14174154"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"pkad059","DOI":"10.1093\/jncics\/pkad059","article-title":"Impact of functional disability on health-care use and medical costs among cancer survivors","volume":"7","author":"Tak","year":"2023","journal-title":"JNCI Cancer Spectr."},{"key":"ref_8","first-page":"4346","article-title":"Multimorbidity in people living with and beyond cancer: A scoping review","volume":"13","author":"Ahmad","year":"2023","journal-title":"Am. J. Cancer Res."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e2339116","DOI":"10.1001\/jamanetworkopen.2023.39116","article-title":"Chemotherapy-related toxic effects and quality of life and physical functioning in older patients","volume":"6","author":"Baltussen","year":"2023","journal-title":"JAMA Netw. Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"102205","DOI":"10.1016\/j.esmoop.2023.102205","article-title":"Systemic inflammation and cancer-related frailty: Shifting the paradigm toward precision survivorship medicine","volume":"9","year":"2024","journal-title":"ESMO Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"105858","DOI":"10.1016\/j.archger.2025.105858","article-title":"Cancer-treatment-induced accelerated aging in older adult cancer survivors: A call for actions for future perspectives in geriatric oncology","volume":"134","author":"Locquet","year":"2025","journal-title":"Arch. Gerontol. Geriatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1016\/j.ygyno.2014.10.013","article-title":"Cancer-related and treatment-related fatigue","volume":"136","author":"Wang","year":"2015","journal-title":"Gynecol. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"8884","DOI":"10.1200\/JCO.2005.02.2343","article-title":"Health behaviors of cancer survivors: Examining opportunities for cancer control intervention","volume":"23","author":"Bellizzi","year":"2005","journal-title":"J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1016\/j.jshs.2023.01.003","article-title":"A randomized controlled trial of Promoting Physical Activity in Regional and Remote Cancer Survivors (PPARCS)","volume":"13","author":"Hardcastle","year":"2024","journal-title":"J. Sport Health Sci."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1136\/bmj.e70","article-title":"Physical activity for cancer survivors: Meta-analysis of randomised controlled trials","volume":"344","author":"Fong","year":"2012","journal-title":"BMJ"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1186\/s12955-020-01448-3","article-title":"The role of physical activity in cancer survivors\u2019 quality of life","volume":"18","author":"Liska","year":"2020","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Reiner, M., Niermann, C., Jekauc, D., and Woll, A. (2013). Long-term health benefits of physical activity\u2014A systematic review of longitudinal studies. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-813"},{"key":"ref_18","unstructured":"Blewett, L.A., Drew, J., King, M.L., Williams, K.C.W., and Lin, S. (2023). IPUMS Health Surveys: National Health Interview Survey, IPUMS. Available online: https:\/\/www.ipums.org\/projects\/ipums-health-surveys\/d070.v7.1."},{"key":"ref_19","unstructured":"National Center for Health Statistics (2025, July 23). National Health Interview Survey, 2021, Available online: https:\/\/www.cdc.gov\/nchs\/nhis.htm."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.jgo.2016.01.009","article-title":"Patient-reported versus objectively measured physical function and mortality risk among cancer survivors","volume":"7","author":"Brown","year":"2016","journal-title":"J. Geriatr. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2577","DOI":"10.1002\/cncr.23448","article-title":"Physical and psychological long-term and late effects of cancer","volume":"112","author":"Stein","year":"2008","journal-title":"Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1002\/pon.2072","article-title":"Cancer survivors\u2019 exercise barriers, facilitators and preferences in the context of fatigue, quality of life and physical activity participation: A questionnaire survey","volume":"22","author":"Blaney","year":"2013","journal-title":"Psycho-Oncology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2198","DOI":"10.1200\/JCO.2007.14.6217","article-title":"Cancer survivors\u2019 adherence to lifestyle behavior recommendations and associations with health-related quality of life: Results from the American Cancer Society\u2019s SCS-II","volume":"26","author":"Blanchard","year":"2008","journal-title":"J. Clin. Oncol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e000250","DOI":"10.1136\/esmoopen-2017-000250","article-title":"Biology of premature ageing in survivors of cancer","volume":"2","author":"Kirkland","year":"2017","journal-title":"ESMO Open"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"573","DOI":"10.1016\/j.critrevonc.2013.07.001","article-title":"Effect of physical exercise on muscle mass and strength in cancer patients during treatment: A systematic review","volume":"88","author":"Stene","year":"2013","journal-title":"Crit. Rev. Oncol. Hematol."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Giallauria, F., Cirillo, P., Pacileo, M., Piepoli, M.F., and Vigorito, C. (2023). Exercise training in elderly cancer patients: A systematic review. Cancers, 15.","DOI":"10.3390\/cancers15061671"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1001\/jamaoncol.2016.6914","article-title":"Comparison of pharmaceutical, psychological, and exercise treatments for cancer-related fatigue: A meta-analysis","volume":"3","author":"Mustian","year":"2017","journal-title":"JAMA Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1136\/bjsports-2017-098285","article-title":"Therapeutic effects of aerobic and resistance exercises for cancer survivors: A systematic review of meta-analyses of clinical trials","volume":"52","author":"Fuller","year":"2018","journal-title":"Br. J. Sports Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"48498","DOI":"10.1016\/j.jshs.2023.12.001","article-title":"Suppressive effects of exercise-conditioned se-rum on cancer cells: A narrative review of the influence of exercise mode, volume, and intensity","volume":"13","author":"Bettariga","year":"2024","journal-title":"J. Sport Health Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.jshs.2023.07.002","article-title":"Effects of personalized exercise prescriptions and social media delivered through mobile health on cancer survivors\u2019 physical activity and quality of life","volume":"12","author":"Gao","year":"2023","journal-title":"J. Sport Health Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"101066","DOI":"10.1016\/j.jshs.2025.101066","article-title":"Exercise as a cancer treatment: New evidence from preclinical and early phase clinical studies","volume":"14","author":"Courneya","year":"2025","journal-title":"J. Sport Health Sci."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2375","DOI":"10.1249\/MSS.0000000000002116","article-title":"Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable","volume":"51","author":"Campbell","year":"2019","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"57989","DOI":"10.1016\/j.jshs.2024.03.002","article-title":"Occupational physical activity, all-cause, cardiovascular disease, and cancer mortality in 349,248 adults: Prospective and longitudinal analyses of the MJ Cohort","volume":"13","author":"Stamatakis","year":"2024","journal-title":"J. Sport Health Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"101018","DOI":"10.1016\/j.jshs.2024.101018","article-title":"Associations of adiposity and device-measured physical activity with cancer incidence: UK Biobank prospective cohort study","volume":"14","author":"Strain","year":"2025","journal-title":"J. Sport Health Sci."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"101017","DOI":"10.1016\/j.jshs.2024.101017","article-title":"Effect of exercise for patients with advanced lung cancer and cancer-related fatigue: A systematic review and meta-analysis","volume":"14","author":"Hu","year":"2025","journal-title":"J. Sport Health Sci."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/856\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T09:08:47Z","timestamp":1768986527000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/856"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,21]]},"references-count":35,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020856"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020856","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,21]]}}}