Heterogeneity in biological, physical, and cognitive aging in older breast cancer survivors and controls
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PROJECT SUMMARY The past two decades have witnessed dramatic advances in our understanding of aging processes, with data demonstrating heterogeneity in biological, functional, and cognitive aging. Understanding this heterogeneity, and factors that influence aging, has important implications for the clinical care of older individuals. Cancer is a leading disease of older age, second only to cardiovascular disease, and cancer has been suggested as a disease driver of aging. Heterogeneity in physical and cognitive functional changes suggests that there are important modifiers to the aging processes. However, significant gaps in knowledge remain, including how rates of aging differ among survivors vs. non-cancer populations, whether rates of biological aging explain observed heterogeneity in physical and cognitive function, and what are the potential modifiable factors that could be a clinical survivorship intervention target. The current proposed research will directly address the NIA mission to understand the clinical and biological nature of the aging process, the role that cancer treatment plays in this process, and identify targets for extending healthy years of life. The goals of the current study are to 1) compare longitudinal biological aging in older breast cancer survivors to non-cancer controls, 2) determine whether physical and cognitive functional declines are greater in survivors than controls and whether biological aging mediates this effect, and 3) evaluate the impact of sleep disturbances, a modifiable behavior, on aging patterns. We will leverage a cohort of 368 survivors and similar numbers of age-, race-, education-, and site- frequency-matched non-cancer controls enrolled pre-systemic treatment/enrollment and complete annual follow up visits through 36-months, using biospecimens collected at annual visits to measure biological aging. This study offers an extraordinary opportunity to efficiently address whether and how cancer and its treatments accelerate aging and will provide important new data about clinically important aging outcomes.
