@entity308 and quality of life before and after @entity0 in older @entity1 from the XXXX 's Health Initiative.

@entity1 @entity308 @entity0 @entity5 @entity158 @entity25
PURPOSE: Distress and reduced quality of life (QOL) are common among @entity1 with @entity5 . No study has compared these variables after @entity0 to pre- @entity5 diagnosis levels. METHODS: Data on @entity1 with @entity0 50  years of age or older (n   =   6949) were analyzed from the @entity1 's Health Initiative (1993-2013). Health-related QOL (physical function, mental health) was measured using Rand-36. @entity308 were measured with the six-item Center for Epidemiologic Studies @entity308 scale. Assessments occurred before and after the @entity5 diagnosis. @entity5 QOL and @entity308 to levels post-diagnosis and tested whether pre- @entity5 physical activity, stressful life events, @entity25 , and @entity158 predicted post-diagnosis outcomes. RESULTS: Compared with pre- @entity5 levels, @entity308 increased (20.0  % increase at 0-6  months, 12.9  % increase at 6-12  months), while physical function (-3.882 points at 0-6  months, -3.545 at 6-12  months) and mental health decreased (-2.899 points at 0-6  months, -1.672 at 6-12  months) in the first year after diagnosis (all p   <   .01). @entity308 returned to pre- @entity5 levels after 10  years, but QOL remained significantly lower. At more than 10  years post-diagnosis, physical function was 2.379 points lower than pre- @entity5 levels (p   <   0.01) while mental health was 1.922 points lower (p   <   0.01). All pre- @entity5 predictors were associated with all outcomes. @entity158 predicted uniquely greater decreases in physical function post-diagnosis. CONCLUSIONS: @entity308 increased and QOL decreased following @entity0 compared with pre- @entity5 levels, particularly in the first year. IMPLICATIONS FOR CANCER SURVIVORS: QOL may remain lower for years after @entity0 , although decreases are small.
