The relationship between age, anxiety, and depression in older adults with cancer

Abstract

Objective In older men with prostate cancer, aging is associated with reduced anxiety and increased depression. The purpose of this study was to examine the association among age, anxiety, and depression in a cohort of older adults receiving chemotherapy. Methods This is a secondary analysis of a prospective longitudinal study investigating chemotherapy toxicity in older adults with cancer. Baseline data (pre‐chemotherapy) included: age, sociodemographics, tumor and treatment factors, functional status, comorbidities, psychological state (measured by the Hospital Anxiety and Depression Scale), and social support. Univariate and multiple regression analyses were conducted to test the relationship between age, anxiety, and depression. Results The average age of the 500 patients (56% females) was 73.1. The majority had late stage disease: 22% Stage III and 61% stage IV. Clinically significant depression was reported in 12.6%. Clinically significant anxiety was reported in 20.9%. In univariate analyses, there was no association between anxiety and age, or depression and age. In multivariable analyses, older age (p=0.05) was associated with decreased anxiety, as well as lack of social support (p<0.01) and increased number of comorbidities (p<0.01). In multivariable analysis, depression was associated with lack of social support (p<0.01), increased number of comorbidities (p<0.01), and advanced stage (p<0.01). Conclusions This study supports previous research that anxiety decreases with age in older adults with cancer. However, depression remained constant with increasing age. Greater resources and attention to identifying and treating the psychological sequelae of cancer in older adults are warranted. Copyright © 2014 John Wiley & Sons, Ltd.

Geriatric assessment findings independently associated with clinical depression in 1092 older patients with cancer: the ELCAPA Cohort Study

“…Several studies support our finding that medical comorbidities are associated with an increased prevalence of depression , most probably because of higher psychological burden.…”

Cancer Type and Risk of Newly Diagnosed Depression Among Elderly Medicare Beneficiaries With Incident Breast, Colorectal, and Prostate Cancers

“…For example, studies found that individuals diagnosed at an advanced stage have a higher risk of developing depression compared with those diagnosed at an early stage. 5,14,15 Cancer treatment can also affect the risk of developing depression. Retrospective studies among women with breast cancer reported a significant association between chemotherapy treatment and the risk of depression.…”

Psychische Belastung und psychosoziale Unterstützung älterer Krebspatienten

“…In diesem Zusammenhang sind vor allem die Zunahme an Gebrechlichkeit, komorbiden kör-perlichen Erkrankungen, Funktionseinschränkungen, kognitiven Defiziten und Einschränkungen bei der Alltagsbewäl-tigung zu nennen [14,36]. Durch das gleichzeitige Auftreten mehrerer behandlungsbedürftiger Erkrankungen werden bei älteren Patienten oft mehrere Medikamente verordnet ("Polypharmazie"), deren Wechselwirkungen in der Regel schwer vorhersehbar sind.…”

“…Verschiedene Studien und Übersichts-arbeiten zeigen, dass bei älteren Krebspatienten Angststörungen und Depressionen zu den häufigsten psychischen Störungen zählen [11,19,36]. So werden bei bis zu 23% der älteren Krebspatienten Angststö-rungen berichtet.…”

“…Das mittlere Erkrankungsalter von Krebspatienten liegt aktuell bei 69 Jahren, mehr als die Hälfte aller Krebspatienten ist älter als 65 Jahre [36]. Zunehmendes Alter gilt als starker Risikofaktor für die Entstehung einer Krebserkrankung [4].…”