Symptom distress in older adults during cancer therapy: Impact on performance status and quality of life

Abstract

This study aims to identify a sub-group of older patients who experience a higher level of symptoms of distress during cancer therapy. The symptoms that had the greatest impact on the patients' performance status and quality of life (QoL) are also identified. This cross-sectional study used secondary data from a convenience sample of 120 patients, 65years of age and older, receiving cancer therapy. The measuring instruments used included the Symptom Distress Scale, the Karnofsky Performance Scale (KPS) and the Functional Assessment of Cancer Therapy-General (FACT-G). Hierarchical cluster analysis was used to categorize the patients into groups. The patients had multiple symptoms, with a mean number of 5±3 symptoms per patient. Mood disturbance was the most prevalent (87%), while nausea (28%) was the least prevalent. Approximately 28% and 72% of the patients fell into the high-symptom and low-symptom groups, respectively. The high-symptom group reported significantly lower mean KPS scores, and FACT-G sub-scale and total scores (p<0.01). Impaired mobility had the strongest standardized coefficients in the KPS (-0.63; p<0.01), the FACT-G functional (-0.49; p<0.05) and the physical (-0.45; p<0.05) sub-scales. Concentration difficulties had the strongest standardized coefficients (-0.47; p<0.01) in the FACT-G total. Most of the older patients in this study reported suffering from a multitude of symptoms, with mood disturbance being the most prevalent. The older patients in the high-symptom group had a significantly lower performance status and QoL compared to the patients in the low-symptom group.