{"doi":"10.1093/jnci/djaf337","title":"Neighborhood deprivation on increasing deficit accumulation in older breast cancer survivors and noncancer control individuals","abstract":"BACKGROUND: Neighborhood characteristics can affect aging and health. We tested the effects of neighborhood deprivation on deficit accumulation frailty scores in a prospective cohort of breast cancer survivors vs control individuals aged 60 to 98 years. METHODS: Newly diagnosed, nonmetastatic breast cancer survivors (n = 477) and frequency-matched control individuals (n = 434) were enrolled between 2010 and 2023, with up to 5-year follow-up through 2024. Deficit accumulation was measured using a 48-item index (scores of 0-1); a clinically meaningful deficit increase was defined by a 0.06 score increase. Neighborhood deprivation was assessed using the Area Deprivation Index (ADI) at enrollment census block group and categorized into tertiles. Cause-specific Cox models tested the association between ADI and risk of deficit accumulation increase. RESULTS: Participants living in more deprived areas (second and third tertiles of ADI) had a higher risk of increased deficit accumulation (adjusted hazard ratios = 1.38, 95% CI = 1.01 to 1.89, P = .04 and 1.46, 95% CI = 1.07 to 1.94, P = .01 vs first tertile, respectively). Independent of ADI, being a survivor (vs a control individual) was associated with greater risk of increased deficit accumulation (adjusted hazard ratio = 1.69, 95% CI = 1.32 to 2.17, P < .001). Patterns of cumulative incidence rates of increased deficit accumulation differed by ADI: Survivors treated with chemotherapy (with or without hormone therapy) living in more vs less deprived areas had a 20% higher incidence of increased deficit accumulation within 1 year (P = .004), while survivors receiving hormone therapy alone and noncancer control individuals had their most pronounced differences by 4 years (10%, P = .32 and 10%, P = .05, respectively). CONCLUSIONS: Neighborhood deprivation may increase deficit accumulation, with an apparent acceleration of effects among older (≥60 years of age) breast cancer survivors treated with chemotherapy.","journal":"JNCI Journal of the National Cancer Institute","year":2025,"id":582852,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5974,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":403482,"name":"Wanting Zhai","orcid":null,"position":1,"is_corresponding":false},{"id":269686,"name":"Jaeil Ahn","orcid":"0000-0001-7998-4759","position":2,"is_corresponding":false},{"id":278735,"name":"Tim A. Ahles","orcid":"0000-0002-7936-2818","position":3,"is_corresponding":false},{"id":923943,"name":"Ashley Artese","orcid":"0000-0001-8811-566X","position":4,"is_corresponding":false},{"id":1234244,"name":"Iwalola Awoyinka","orcid":"0000-0003-0536-0550","position":5,"is_corresponding":false},{"id":298119,"name":"Judith Carroll","orcid":"0000-0001-5516-0819","position":6,"is_corresponding":false},{"id":362880,"name":"Harvey Jay Cohen","orcid":null,"position":7,"is_corresponding":false},{"id":435686,"name":"Kathleen Van Dyk","orcid":"0000-0003-1500-930X","position":8,"is_corresponding":false},{"id":402363,"name":"Deena Graham","orcid":"0000-0003-1111-6984","position":9,"is_corresponding":false},{"id":337736,"name":"Heather Jim","orcid":"0000-0001-7353-3711","position":10,"is_corresponding":false},{"id":260693,"name":"Brenna C. McDonald","orcid":"0000-0001-6895-4490","position":11,"is_corresponding":false},{"id":388669,"name":"Zev M. Nakamura","orcid":"0000-0001-9695-1457","position":12,"is_corresponding":false},{"id":426788,"name":"Sunita K. Patel","orcid":"0000-0002-9023-8391","position":13,"is_corresponding":false},{"id":641923,"name":"Kelly E. Rentscher","orcid":"0000-0003-1887-3953","position":14,"is_corresponding":false},{"id":402364,"name":"James C. Root","orcid":"0000-0001-7332-6165","position":15,"is_corresponding":false},{"id":27595,"name":"Andrew J. Saykin","orcid":"0000-0002-1376-8532","position":16,"is_corresponding":false},{"id":337738,"name":"Brent J. Small","orcid":"0000-0002-7444-4689","position":17,"is_corresponding":false},{"id":696353,"name":"Yiwey Shieh","orcid":"0000-0002-0159-7748","position":18,"is_corresponding":false},{"id":292842,"name":"Jeanne S. Mandelblatt","orcid":"0000-0002-2490-005X","position":19,"is_corresponding":false},{"id":299778,"name":"Traci N. Bethea","orcid":"0000-0003-3205-2078","position":20,"is_corresponding":false},{"id":630693,"name":"Eunji Choi","orcid":"0000-0003-1315-1433","position":0,"is_corresponding":true}],"reference_count":44,"raw_metadata":null,"created_at":"2026-07-19T02:58:59.653747Z","pmid":"41273782","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}