Table 1.
Odds of having medical care disruptions during the COVID-19 pandemic among older breast cancer survivors
| No disruptions N = 135 | Disruptions N = 127 | Factors associated with having medical care disruptions | ||||
|---|---|---|---|---|---|---|
| Percent (n) or mean (SD) | Unadjusted OR (95% CI) |
p value | Adjusted OR (95% CI)a |
p value | ||
| Demographic factors | ||||||
| Age, years | 68.0 (5.2) | 67.8 (5.5) | 0.993 (0.95,1.04) | 0.753 | 0.99 (0.95, 1.04) | 0.548 |
| Race | – | |||||
| Non-White | 47.5 (19) | 52.5 (21) | 1.21 (0.62, 2.37) | 0.580 | ||
| White | 52.3 (116) | 47.7 (106) | Reference | |||
| Education, years, per 1-year increase in education | 15.1 (2.3) | 16.0 (2.0) | 1.22 (1.08, 1.37) | < 0.001 | 1.23 (1.09, 1.39) | 0.001 |
| Clinical factors | ||||||
| Months from diagnosis | 33.5 (18.0) | 30.6 (16.7) | 0.99 (0.98, 1.01) | 0.191 | 0.99 (0.97, 1.01) | 0.168 |
| Stage (AJCC v.6) | ||||||
| 0–I | 52.2 (108) | 47.8 (99) | Referent | – | ||
| II or III | 48.9 (22) | 51.1 (23) | 1.14 (0.60, 2.17) | 0.689 | ||
| Systemic treatment | – | |||||
| Chemotherapy ± hormonal | 45.1 (23) | 54.9 (28) | 1.38 (0.75, 2.55) | 0.307 | ||
| Hormonal only | 53.1 (112) | 46.9 (99) | Referent | |||
| Comorbidities (prior to COVID), number | 2.7 (1.8) | 3.1 (2.0) | 1.13 (0.99, 1.29) | 0.071 | 1.09 (0.94,1.26) | 0.238 |
| Prescription drugs (prior to COVID), number | 3.6 (2.2) | 4.0 (2.6) | 1.08 (0.97, 1.19) | 0.170 | – | |
| COVID-related factors | ||||||
| Family/household member lost their job (yes/no) | 34.5 (10) | 65.5 (19) | 2.20 (0.98, 4.93) | 0.056 | – | |
| COVID-related worriesb | 16.8 (6.5) | 18.5 (9.2) | 1.03 (1.00, 1.06) | 0.085 | – | |
| Per capita COVID deaths in county per 1000c | 0.9 (0.9) | 0.8 (0.8) | 0.86 (0.65, 1.15) | 0.319 | 0.80 (0.58, 1.11) | 0.179 |
| Psychosocial factors prior to COVID (from most recent study assessment prior to COVID) | ||||||
| Depressive symptomsd | 5.5 (5.4) | 7.5 (8.6) | 1.04 (1.00, 1.08) | 0.033 | – | |
| Anxietye | 27.5 (5.5) | 28.8 (7.5) | 1.03 (0.99, 1.07) | 0.120 | – | |
| Tangible social supportf | 83.8 (19.3) | 76.9 (23.8) | 0.99 (0.97, 1.00) | 0.012 | 0.98 (0.97, 1.00) | 0.006 |
| Emotional supportf | 82.7 (17.9) | 78.1 (20.4) | 0.987 (0.98, 1.00) | 0.053 | – | |
| Sleep disturbanceg | 52.4% (44) | 47.6 (40) | 0.95 (0.57, 1.60) | 0.849 | – | |
| FACT–G Totalh | 71.0 (9.1) | 66.2 (11.8) | 0.96 (0.93, 0.98) | < 0.001 | – | |
| Model fit statistics BIC = 365.11; AIC = 340.37; C = 0.673 | ||||||
aLogistic regression including all variables on the table
bCOVID-related worries based on 7 items from COVID survey. Scores range from 7 to70, with higher scores reflecting more COVID worries
cBased on cumulative death rates per capita in county of residence from pandemic to date of interview per 1000 based on data reported to the NY Times [11] and the US Census [12]
dBased on the CES-D, Center for Epidemiologic Studies Depression Scale [16]. Scores range from 0 to 60, with higher scores reflecting more psychological distress
eBased on the State-Trait Anxiety Inventory [15]. Scores range from 20 to 80, with higher scores reflecting more anxiety
fBased on the normalized MOS-Tangible social support [18]. Scores range from 0 to 100, with higher scores reflecting more tangible social support
gThe presence of a sleep disturbance (yes/no) was determined from the endorsement of one or both of 2 questions [24] from CES-D: “During the last 7 days, I have been sleeping well” (with subjects who reported “not at all” or “a little bit” coded as having a sleep disturbance) and “During the past week, my sleep was restless” (with subjects who reported “occasionally or moderate amount of time” or “most or all the time” coded as having a sleep disturbance
hBased on the FACT-G [19]. Scores range from 0 to 84, with higher scores reflecting better functioning