Higher emotional and psychiatric sequelae amongst elderly early-stage cancer patients undergoing chemotherapy

Abstract

symptoms. In order to provide adequate and appropriate psychosocial support for elderly cancer patients, there is a need to investigate the differential psychological impact that these patients face, in comparison to younger patients. Objectives: In the context of a local healthcare setting, the aim of this study was to (1) investigate if elderly patients had higher levels of psychiatric symptoms (depression, anxiety and distress) than younger patients; (2) examine the changes in the levels of psychiatric symptoms over a period of time; (3) investigate changes in the number of caseness of psychiatric morbidities for each patient population over the same period of time. Methods: 157 cancer patients from the National University Cancer Institute, Singapore, participated in this longitudinal study. 35% (n= 54) of the patients were aged 61 years and above (elderly). Selfreport questionnaires measuring distress (Distress Thermometer), and depression and anxiety (Hospital Anxiety and Depression Scale) were administered at 3 time points (baseline, 2 months and 5 months). An independent sample t-test was used to compare the levels of distress, depression and anxiety for both groups at baseline. ANOVAwas used to compare the measures both across time, as well as the elderly patients with the younger ones. Chi-square tests were used to analyse the prevalence of caseness in the two groups of patients. Results: Results indicated that for all symptoms at baseline, elderly patients did not report experiencing significantly higher levels compared to younger patients. For all patients, comparing baseline to 2 months, and baseline to 5 months, there was a significant decrease in the all symptoms, except for distress at 5 months which showed a marginally significant decrease. However, comparing between elderly and young patients over time, there was no significant difference in the levels of all symptoms. In addition, although marginally significant, the prevalence of caseness in the elderly patients was higher compared to the young patients, for depression at baseline (χ[1,118] = 3.577, p= .059) and for distress at 2 months (χ[1,73] = 3.273, p= .070). Apart from these two exceptions, there was no significant difference between elderly and young patients in the prevalence of caseness for all the symptoms at all three time points. Conclusion: This study has shown that elderly patients generally do not experience more symptoms of depression, anxiety or distress compared to younger patients. Instead, all patients exhibit a trajectory of decreasing symptoms over time. Attention should be paid however, to elderly caseness patients. Future research could investigate the profile of elderly caseness patients and the changes in symptom level over time, to allow for healthcare professionals to provide the appropriate psychosocial support for them. Disclosure of interest: None declared.