Impact of pain on functional status, quality of life, and cognition in older adults with prostate cancer.

e23084 Background: Pain is a common symptom in patients with cancer that can be compounded by aging. Studies of its multidimensional impact on functional status, physical and cognitive function, and health-related quality of life (HRQOL) in older patients with prostate cancer are limited. Methods: Patients with prostate cancer ≥50y harmonized across three single-institution prospective registries: Cancer and Aging Resilience Evaluation (CARE), Web-enabled CARE (WeCARE), and Cognition in Advanced Prostate Cancer Patients Treated with Androgen Blockers (CAPITAL) completed a self-reported geriatric assessment (GA) at baseline (time of presentation to a medical oncologist). Pain was measured on a 10-point Likert scale ("In the past 7 days, how would you rate your pain on average?"), and based on prior literature moderate-severe pain defined as ≥ 4. Functional status was measured by Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL). Physical function was measured by self-reported ECOG performance status and ability to walk one block, perform vigorous activities, and climb one flight of stairs. HRQOL measured using PROMIS 10-item Global Health questionnaire; social activity by 2 items from MOS Social Support survey; and cognition by PROMIS Cognitive Function Short Form 4a. Multivariable logistic regression models assessed associations between pain and GA impairments adjusting for age, race, education, marital, and employment status. Results: We included 175 patients, median age 70yrs (range: 51-93), 69% White, 23% Black, 63% married, 57% disabled, retired, or unemployed, and 53% with college education or above. A total of 45% of patients reported moderate-severe pain. Table 1 reports adjusted odds ratios and 95% confidence intervals of associations of pain and GA impairments. Conclusions: Pain is highly prevalent among patients with prostate cancer at time of presentation and associated with significant impairments in functional status, physical and cognitive function, social activity and HRQOL. These findings underscore the importance of routine pain assessment and identifying strategies to reduce pain and minimize its impact on patient well-being. Future work needs to assess impact of cancer treatment and stage, comorbidities, and age-related conditions that may compound pain. Association of moderate-severe pain with GA impairments. Variables Adjusted odds ratio (aOR) 95% Confidence interval (CI) P value IADL 4.09 2.09-7.96 ≤0.001 ADL 5.81 2.01-16.84 0.001 Walking 1 block 1.98 1.05-3.76 0.04 Climbing 1 flight of stairs 2.31 1.15-4.63 0.02 Vigorous Activities 4.32 1.77-10.52 0.001 Self-rated ECOG Performance Status 5.23 2.27-12.06 ≤0.001 Health-Related Quality of Life (HRQOL) 3.88 2.02-7.47 ≤0.001 Cognitive Function 1.89 0.97-3.69 0.06 Social Activities 2.80 1.35-5.78 0.005