Depression in Geriatric Cancer Patients: Guide to Assessment and Treatment

Goldberg, Richard J.; Cullen, Leah Oseas

doi:10.1080/0742-969x.1986.11882560

Cited by 9 publications

(6 citation statements)

References 39 publications

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“…Cancer is predominantly a disease of the elderly and it has been estimated that as many as half of all elderly cancer patients will experience significant depressive symptoms. 11 In this study the mean age of patients prescribed antidepressant medication was significantly lower than for all patients (61.3 years in the treated group vs 71.4 years in the nontreated group, P = 0.002). The reasons for this pattern are unclear, but it may be that depression is not identified as easily in the elderly as in younger patients.…”

Section: Discussioncontrasting

confidence: 52%

A survey of antidepressant prescribing in the terminally ill

1999

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Depression is a symptom in a quarter of patients admitted to a palliative care unit, but little is known of how depression in terminally ill patients is treated. We reviewed 1046 consecutive patient admissions, of whom 106 (10%) were prescribed antidepressant medication while under the care of a palliative care team. Of these patients, 21 were prescribed antidepressants when under the care of the home care team, but 80 patients (76%) were started on medication during the final 2 weeks of life. There was consequently insufficient time for the medication to have any therapeutic effect. Seventeen patients were discharged home on antidepressant medication. Three patients were referred for a psychiatric assessment. Patients prescribed antidepressants were significantly younger (P = 0.002) than those who were not. There were no prescriptions for psychostimulants. Although the numbers of patients prescribed antidepressant medication were low in all disease groups, it was notable that patients with breast cancer were prescribed antidepressant medication more frequently than any other patient group. We conclude that there appears to be a need for a coordinated approach to both the assessment and the treatment of depression in terminally ill patients.

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Section: Discussioncontrasting

confidence: 52%

A survey of antidepressant prescribing in the terminally ill

1999

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“…However, given the fact that the newer studies led to different treatment schemes based on age, e.g., for GBM, it seems to be debatable to assign patients to therapy schemes considering solely their age in light of our findings: deciding on a more or less aggressive treatment should be based not only on KPS or calendric age alone, but also on patient perceived HRQoL. Undoubtedly, especially in elderly HGG patients, we should include geriatric assessment what seems to be helpful in geriatric cancer patients in general [37,38].…”

Section: Significance Of Age and Kpsmentioning

confidence: 92%

Health-related quality of life and distress in elderly vs. younger patients with high-grade glioma—results of a multicenter study

Renovanz

Hickmann

Nadji-Ohl

et al. 2020

Support Care Cancer

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Objective Half of all newly diagnosed patients with glioblastoma are > 65 years still with a poor prognosis. Preserving quality of life is of high importance. However, patient reported outcome (PRO) data in this patient group is rare. The aim was to compare health-related quality of life (HRQoL) and distress between elderly and younger patients with high-grade glioma (HGG). Methods We used baseline data of a prospective study where HGG patients were enrolled from 4 hospitals. Distress was measured using the distress thermometer (DT), HRQoL using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) plus brain module (BN20). We compared distress and HRQoL by age (≥ 65 vs. < 65 years), gender, performance score, and time since diagnosis using multivariate linear and logistic regressions. Results A total of n = 93 (30%) out of n = 309 patients were ≥ 65 years (mean 70 years, range 65-86 years). Mean DT score of elderly patients (5.2, SD 2.6) was comparable with younger patients (4.9, SD 2.6). Elderly patients reported significantly lower global health (GHS, mean elderly vs. younger; 50.8 vs. 60.5, p = 0.003), worse physical (56.8 vs. 73.3, p < 0.001) and lower cognitive functioning (51.1 vs. 63.2, p = 0.002), worse fatigue (52.5 vs. 43.5, p = 0.042), and worse motor dysfunction (34.9 vs. 23.6, p = 0.030). KPS and not age was consistently associated with HRQoL. Conclusion Physical functioning was significantly reduced in the elderly compared with younger HGG patients, and at the same time, emotional functioning and DT scores were comparable. KPS shows a greater association with HRQoL than with calendric age in HGG patients reflecting the particular importance for adequate assessment of HRQoL and general condition in elderly patients.

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“…Greer & Silberfarb (1982) suggested that the emotional impact of a cancer diagnosis; side‐effects of treatment; progression of cancer with associated disability and symptoms; and cerebral dysfunction associated with carcinomatosis were all important factors. Goldberg & Cullen (1986) believed that the five psychosocial factors leading to significant depressive symptoms were disruption of key relationships; dependence; disability; disfigurement and approaching death. The so called ‘crisis points’ of a cancer illness, i.e.…”

Section: Introductionmentioning

confidence: 99%

Depression in palliative care patients - a prospective study

Lloyd‐Williams

Friedman

2001

European Journal of Cancer Care

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Psychological and psychiatric morbidity can be a major source of distress to terminally ill patients and their relatives and friends. A prospective study was carried out to determine the prevalence of undiagnosed depression in palliative care patients and to determine whether factors such as age, previous psychiatric history and perceived social support have any association with the development of depression when patients have advanced metastatic cancer. Patients aged between 18 and 70 years who had a prognosis of < or = 6 months and who were receiving palliative care only for advanced metastatic cancer were interviewed using the Present State examination interview and a semi-structured interview to determine social support, information needs and past psychiatric history. One hundred patients were recruited and the prevalence of depression according to International Classification of Diseases 10 criteria was 22%. Perceived informal social support and past psychiatric history were not associated with being a case of depression but perceived information needs had a weak association. Younger patients and patients with breast cancer were more likely to be identified as being cases of depression. Further research is necessary to explore the aetiology and outcome of depression in palliative care. A high index of suspicion for depression should be maintained for younger patients with advanced metastatic cancer.

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Depression in Geriatric Cancer Patients: Guide to Assessment and Treatment

Cited by 9 publications

References 39 publications

A survey of antidepressant prescribing in the terminally ill

A survey of antidepressant prescribing in the terminally ill

Health-related quality of life and distress in elderly vs. younger patients with high-grade glioma—results of a multicenter study

Depression in palliative care patients - a prospective study

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