Abstract
•Discuss symptom burden and quality of life for older adults receiving ongoing oncology care for advanced cancer.•Recognize clinical and demographic factors associated with higher symptom burden and lower quality of life among older adults receiving ongoing oncology care for advanced cancer. Identifying factors associated with higher symptom burden and lower quality of life among older adults with advanced cancer can help target palliative care services to patients' needs. To identify demographic and clinical characteristics associated with higher symptom burden and lower quality of life among older adults with advanced cancer. We conducted a secondary analysis of baseline data from CONNECT, a multisite primary palliative care intervention trial that enrolled patients with advanced cancer receiving oncology treatment from 17 practices in Western Pennsylvania. Symptom burden was measured using the Edmonton Symptom Assessment Scale (ESAS; range 0-90, higher scores = higher symptom burden) and quality of life was measured using the FACIT-Pal (range 0-184, higher scores = better quality of life). Predictors included demographic (age, sex, race, education, marital status, ability to manage on income) and clinical variables (cancer type, treatment type, functional status assessed by ECOG performance status). Among 449 older adults (mean age 75 ±7 years; 53% female), the mean ESAS score was 23.8 (SD 15.7) and the mean FACIT-Pal score was 132.5 (SD 24.9). In multivariable analyses, difficulty managing on one's income (p=0.01), not being married (p=0.03), and poor functional status (p=0.001) were independently associated with higher symptom burden. Difficulty managing on one's income (p<0.001) and poor functional status (p<0.001) were also independently associated with lower quality of life. Palliative care needs are highest amongst older patients with advanced cancer who have difficulty managing on their incomes, have worse functional status, and do not have a partner at home.
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