Physical and psychosocial outcomes in cancer patients: a comparison of different age groups

Abstract

Summary In a cross-sectional study, we investigated the relationship between age, physical health, social and economic resources, functional status, activities of daily living (ADL) and disease-related variables of 227 patients with cancer. Using multidimensional outcome measures we examined age differences in three age groups (< 45, 46-65, >65 years) and identified predictors of performing ADL. The results indicated that older patients have outcomes similar to those of younger patients. There were no significant differences in quality of life, performance status and physical health among the three age groups. The only areas where age-related differences were found were comorbidity and cancer-related impairments. Patients aged 45-65 years and patients 65 years and older reported a higher level of co-morbidity and more cancer-related impairments than those aged 45 and younger. Although older patients had higher co-morbidity, they showed similar Karnofsky Performance Status (KPS) scores to those of their younger counterparts. The regression analysis revealed social resources, selfreported health, performance status and complexity of care as significant predictors of patients' ADL, but not age, co-morbidity or severity of treatment. The findings support the conclusion that differences in performing ADL between younger and older patients with cancer are minimal and tend to be due to co-morbidity. Thus, treatment should be decided by a patient's physical health rather than by age.

Prevalence of Emotional Distress in Cancer Patients

“…Even though prior studies found to have psychological distress on lower side in older patients [27] but some studies do not found any association between age and psychological well being or distress [28][29]. However, in our study the older age was found to have increased distress on HADS (D) subscale may be due to impact of more extensive surgery or the side effects of chemotherapy or radiotherapy.…”

Co-morbidity and functional deficits independently contribute to quality of life before chemotherapy in elderly cancer patients

“…the start of systemic chemotherapy, for the measurement of QoL. Greimel et al [33] could not demonstrate any interaction between co-morbidity and KPS in their analysis of 227 patients with cancer. In addition, they were unable to demonstrate an age-dependent decline in KPS.…”

Pretreatment factors predicting quality of life after treatment for head and neck cancer

“…This is in line with recommendations from the literature on outcome analysis in this patient group. 21,23,24,67 Some studies of head and neck cancer patients even indicate that younger age is a risk factor for physical dysfunction 57 or depression. 11,14 The factors studied explained a significant percentage of variance of the various domains of QOL after treatment.…”

“…11,20,21 With regard to age, it is often assumed that elderly patients fare worse after treatment, but few data support this view. [21][22][23][24] Functional status, as measured with the Karnofsky performance status (KPS), 25 a reliable and valid instrument to assess the functional status of cancer patients, 26 has been shown to be positively correlated with QOL. 27,28 Last, psychologic status may profoundly influence physical functioning, symptom perception, and mood after treatment.…”