Older Patients Are Less Affected by Radiochemotherapeutic Treatment than Younger

Purpose. The general assumption is that cancer therapy impairs the quality of life in elderly patients more than in younger ones. We were interested in the effects of radiochemotherapeutic treatment on the quality of life of elderly patients compared to younger patients and compared to normative data of a general German population. Methods and Materials. A total of 465 patients completed the EORTC QLQ-C30 questionnaire. Repetitive completion of the questionnaire over time led to 1407 datasets. Our patient cohort contained 197 (42.4%) patients with colorectal cancer followed by 109 (23.4%) patients with head and neck cancer, 43 (9.2%) patients with lung cancer, and 116 (25%) with other types of cancer. Patients were categorized into five age groups, the respective cut-offs being 40, 50, 60, and 70 years. Normative data were drawn from a population study of a general German population. Results. Functional scores and symptom scores were approximately stable between the different age groups. Our data does not suggest a significant difference between the investigated age groups. Advancing age evened out the differences between the normative data of the general German population and the cancer patients in 11 of 15 scores. Conclusions. The general belief about younger patients having fewer physical and psychological problems related to radiochemotherapy needs to be reconsidered. Overall resilience of older patients is apparently underestimated.

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Comprehensive Assessment of the Elderly Cancer Patient: The Feasibility of Self-Report Methodology

Journal of Clinical Oncology ◽

10.1200/jco.2002.20.3.770 ◽

2002 ◽

Vol 20 (3) ◽

pp. 770-775 ◽

Cited By ~ 55

Author(s):

Sally S. Ingram ◽

Pearl H. Seo ◽

Robert E. Martell ◽

Elizabeth C. Clipp ◽

Martha E. Doyle ◽

...

Keyword(s):

Quality Of Life ◽

Social Support ◽

Cancer Patients ◽

Daily Living ◽

Older Patients ◽

Age Groups ◽

Well Being ◽

Self Report ◽

Younger Patients

PURPOSE: Comprehensive geriatric assessment (CGA) has aided the medical community greatly in understanding the quality-of-life issues and functional needs of older patients. With its professional team assessment approach, however, CGA may be time consuming and costly. The goal of the present study was to assess the ability of cancer patients to complete a self-administered CGA and then to characterize cancer patients across multiple domains and age groups. PATIENTS AND METHODS: Two hundred sixty-six male outpatient oncology patients at the Durham Veterans Affairs Medical Center were asked to fill out a survey assessing 10 domains (demographics, comorbid conditions, activities of daily living, functional status, pain, financial well being, social support, emotional state, spiritual well-being, and quality of life). RESULTS: Seventy-six percent of the patients who received their surveys and kept their appointments returned the assessment tool. Older oncology patients had significantly less education (P < .0001), income (P = .05), frequent exercise (P = .01), and chance of being disease free (P = .003) than younger patients. Other findings in older patients were a higher rate of marriage (P = .02), more difficulty in taking medications (P = .05), and less cigarette (P = .03) and alcohol (P = .03) use. Members of all age cohorts reported a sense of social support, with younger patients deriving this more from family and friends than older patients, and older patients deriving social support more from membership in religious communities than younger patients. No differences were found across age groups for number and impact of comorbid illnesses, number of medications, basic and instrumental activities of daily living, pain, overall health rating, financial adequacy, anxiety, depression, and quality of life. CONCLUSION: CGA can be conducted in an outpatient cancer community using a self-report format. Despite the fact that this population varied demographically across age groups and is limited to veterans, this study demonstrated remarkable similarities between younger and older cancer patients in terms of functional status, health states, and quality of life.

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Frequency of Sexual Problems and Related Psychosocial Characteristics in Cancer Patients—Findings From an Epidemiological Multicenter Study in Germany

Frontiers in Psychology ◽

10.3389/fpsyg.2021.679870 ◽

2021 ◽

Vol 12 ◽

Author(s):

Svenja Heyne ◽

Peter Esser ◽

Kristina Geue ◽

Michael Friedrich ◽

Anja Mehnert-Theuerkauf

Keyword(s):

Quality Of Life ◽

Social Support ◽

Cancer Patients ◽

Psychosocial Factors ◽

Multicenter Study ◽

Age Groups ◽

Well Being ◽

Sexual Problems ◽

Significant Difference

BackgroundMultimodal cancer treatments are often associated with sexual problems. Identifying patients with sexual problems could help further elucidate serious issues with their sexuality and thus promote or maintain patients’ sexual health. We aimed to assess the occurrence of sexual problems in patients across different tumor locations and to explore associated sociodemographic, medical and psychosocial factors.MethodsWe included 3,677 cancer patients (mean age 58 years, age range 18–75 years, 51.4% women) from a large epidemiological multicenter study in Germany on average 13.5 months after cancer diagnosis. The occurrence and frequency of sexual problems were assessed via a binary item on the problem checklist of the Distress Thermometer (DT). Controlled associations of these problems with sociodemographic, medical and psychosocial factors including distress (DT), anxiety (GAD-7), depression (PHQ-9), quality of life (EORTC-QLQ-C30), and social support (SSUK-8) are analyzed using logistic regression analysis.ResultsWe found that 31.8% of patients reported sexual problems, with a significant higher proportion in men (40.5%) compared to women (23.7%), OR 2.35, 95% CI [1.80–3.07] and a higher proportion in patients with a partner (35.6%) compared to those without a partner (3.5%), OR 2.83, 95% CI [2.17–3.70]. Tumor location was associated with occurrence of sexual problems: patients with cancer, affecting the male genital organs had the highest chance for sexual problems, OR 2.65, 95% CI [1.18–3.95]. There was no significant difference in the occurrence of sexual problems between age groups OR 0.99, 95% CI [2.13–3.53] and type of therapy (e.g., operation OR 0.91, 95% CI [0.72–1.15]). Sexual problems were further associated with elevated levels of anxiety, OR 1.05, 95% CI [1.02–1.10], less social support, OR 0.93, 95% CI [0.90–0.97] and lower quality of life in terms of impaired functioning (e.g., social function, OR 0.99, 95% CI [0.99–1.00]).ConclusionsSexual problems are commonly reported by patients. Male patients and those living with a partner are more likely to report sexual problems. Sexual problems are associated with different aspects of well-being. The findings imply the practical relevance to screen for sexual problems among patients and identified groups that should be particularly monitored.

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Effect of Providing Cancer Patients With the Audiotaped Initial Consultation on Satisfaction, Recall, and Quality of Life: A Randomized, Double-Blind Study

Journal of Clinical Oncology ◽

10.1200/jco.2000.18.16.3052 ◽

2000 ◽

Vol 18 (16) ◽

pp. 3052-3060 ◽

Cited By ~ 86

Author(s):

L.M.L. Ong ◽

M.R.M. Visser ◽

F.B. Lammes ◽

J. van der Velden ◽

B.C. Kuenen ◽

...

Keyword(s):

Quality Of Life ◽

Cancer Patients ◽

Older Patients ◽

Diagnostic Information ◽

Control Group ◽

Double Blind Study ◽

Double Blind ◽

Younger Patients ◽

Experimental Group

PURPOSE: By means of a randomized double-blind study, the effect of providing taped initial consultations on cancer patients’ satisfaction, recall, and quality of life was investigated. PATIENTS AND METHODS: Consecutive cancer patients referred to either the gynecology or medical oncology outpatient clinic were eligible. Initial consultations were audiotaped. Patients were either provided with the tape (experimental group) or not (control group). Baseline variables included sociodemographics, preferences for information, coping styles, and clinical characteristics. Follow-up (after 1 week and 3 months) variables included attitudes toward the intervention, satisfaction, recall, and quality of life. Assessments took place through mailed questionnaires and telephone interviews. RESULTS: Two hundred one patients were included (response, 71%), 105 in the experimental group and 96 in the control group. Most patients (75%) listened to the tape, the majority of which (73%) listened with others. Almost all patients, both in the experimental group (96%) and control group (98%) were positive about the intervention. Expectations were confirmed; patients provided with the tape were more satisfied (P < .05) and recalled more information (P < .01) than patients without the tape. The intervention did not have an effect on quality of life. An interaction effect was found between the intervention and patients’ age on satisfaction with the taped consultation (P < .01) and recall of diagnostic information (P < .01); access to tapes seems more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients. CONCLUSION: Cancer patients and their families value the taped initial consultation. This intervention enhances their satisfaction and improves their recall of information. Tapes seem more helpful in enhancing satisfaction in younger patients and recall of diagnostic information in older patients.

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Dose Intensity and Hematologic Toxicity in Older Cancer Patients Receiving Systemic Chemotherapy.

Blood ◽

10.1182/blood.v106.11.3124.3124 ◽

2005 ◽

Vol 106 (11) ◽

pp. 3124-3124

Author(s):

Michelle Shayne ◽

Eva Culakova ◽

Marek S. Poniewierski ◽

Debra Wolff ◽

David C. Dale ◽

...

Keyword(s):

Elderly Patients ◽

Cancer Patients ◽

Older Patients ◽

Age Groups ◽

Dose Intensity ◽

Disease Stage ◽

Severe Neutropenia ◽

Hematologic Toxicity ◽

Significant Difference ◽

Older Cancer Patients

Abstract Introduction: Controlled clinical trials have provided limited data on hematologic toxicity and dose intensity of chemotherapy in the elderly. This study evaluated patient and treatment characteristics that contributed to hematologic toxicity in older cancer patients. Methods: A prospective study of 115 randomly selected U.S. community oncology practices was undertaken between March 2002 and March 2005 that included 999 consecutive patients age 70 and older. Major malignancies included cancers of lung (26%), colorectal (15%), lymphoma (13%), breast (13%), ovary (9%), genitourinary (7%), other gastrointestinal (6%), other gynecologic (3%) and head and neck (2%). Primary outcome measures included: anemia (Hgb <10 gm/dL), thrombocytopenia (plts <75k/mm3), severe neutropenia (SN) (neutrophils <500 cells/mm3, or WBC count <1000/mm3), febrile neutropenia (FN) and both planned and actual relative dose intensity (RDI) compared to standard regimens. Univariate and multivariate logistic regression analyses were performed to compare the difference among patients age 70–74 (45%), 75–79 (34%), ≥ 80 (21%). Results: Increasing age was associated with lower actual RDI (P<001), although planned RDI did not differ among age groups. Along with reduced actual RDI in elderly patients, progressively fewer SN or FN events (25%, 24%, and 16%, respectively) occurred across chemotherapy cycles (P=0.036). More advanced stage of disease at the time of treatment was associated with fewer SN or FN events in all cycles (35%, 27%, 21%, and 19% for stages 1–4, respectively) (P=0.017) along with lower RDI (P=.041). Use of taxane-containing regimens decreased with advancing age (37%, 34%, 27%, respectively) (P=0.034). Among the 50% of patients receiving ≥ 85% RDI, there was no significant difference in SN or FN based on age group or stage. Use of anthracycline-containing regimens was associated with development of SN or FN compared to non-anthracycline regimens (P<0.001). Older patients who received ≥ 85% actual RDI experienced more frequent SN or FN in all cycles of chemotherapy (27%) compared with patients who received <85% (22%) (P=.041) although no significant increase with age was observed. There was no statistically significant difference in anemia or thrombocytopenia among the different age groups. Anemia and thrombocytopenia were more prevalent in older patients receiving an anthracycline or platinum-containing regimen. In multivariate analysis, lower risk of SN or FN remained significantly associated with increasing age (P=.044) after adjustment for stage (P=.115) and actual RDI (P=.066). Prophylactic colony-stimulating factor was used in 5% of patients with no significant difference observed among the age groups. Conclusion: This report represents one of the largest studies to date of elderly cancer patients receiving chemotherapy. Neutropenic events increased with actual RDI while decreasing with age and disease stage. Advancing age alone does not appear to increase the risk of hematologic toxicity in older patients receiving full dose intensity chemotherapy. Nevertheless, half of elderly patients in this study received major reductions in actual dose intensity. More information is needed on the impact of reduced dose intensity chemotherapy on long term clinical outcomes in this population.

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Peritoneal Dialysis in Elderly Patients: Clinical Experience

Peritoneal Dialysis International ◽

10.1177/089686080502503s22 ◽

2005 ◽

Vol 25 (3_suppl) ◽

pp. 88-91 ◽

Cited By ~ 12

Author(s):

Edwina A. Brown

Keyword(s):

Quality Of Life ◽

Peritoneal Dialysis ◽

Clinical Outcome ◽

Elderly Patients ◽

Older Patients ◽

Younger Patients ◽

The North ◽

A Prospective Study ◽

Better Than

Many older patients do not cope well with hemodialysis, yet the proportion of older patients on peritoneal dialysis (PD) is considerably lower than for younger patients. This is despite the fact that clinical outcome studies show that older patients cope as well as, if not better than, younger patients on PD. Furthermore, the North Thames Dialysis Study, a prospective study of patients ≥70 years old, has shown that survival, hospitalization, and quality of life were identical for patients on hemodialysis and patients on PD.

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ACUTE KIDNEY INJURY IN ELDERLY PATIENTS

Wiadomości Lekarskie ◽

10.36740/wlek201908109 ◽

2019 ◽

Vol 72 (8) ◽

pp. 1466-1472

Author(s):

Grażyna Kobus ◽

Jolanta Małyszko ◽

Hanna Bachórzewska-Gajewska

Keyword(s):

Acute Kidney Injury ◽

Renal Failure ◽

Acute Renal Failure ◽

Elderly Patients ◽

Older Patients ◽

Age Groups ◽

Kidney Injury ◽

The Elderly ◽

Younger Patients ◽

Common Cause

Introduction: In the elderly, impairment of kidney function occurs. Renal diseases overlap with anatomic and functional changes related to age-related involutionary processes. Mortality among patients with acute renal injury is approximately 50%, despite advances in treatment and diagnosis of AKI. The aim: To assess the incidence of acute kidney injury in elderly patients and to analyze the causes of acute renal failure depending on age. Materials and methods: A retrospective analysis included medical documentation of patients hospitalized in the Nephrology Clinic during the 6-month period. During this period 452 patients were hospitalized in the clinic. A group of 77 patients with acute renal failure as a reason for hospitalization was included in the study. Results: The prerenal form was the most common cause of AKI in both age groups. In both age groups, the most common cause was dehydration; in the group of patients up to 65 years of age, dehydration was 29.17%; in the group of people over 65 years - 43.39%. Renal replacement therapy in patients with AKI was used in 14.29% of patients. In the group of patients up to 65 years of age hemodialysis was 16.67% and above 65 years of age. -13.21% of patients. The average creatinine level in the group of younger patients at admission was 5.16 ± 3.71 mg / dl, in the group of older patients 3.14 ± 1.63 mg / dl. The size of glomerular filtration GFR in the group of younger patients at admission was 21.14 ± 19.54 ml / min, in the group of older patients 23.34 ± 13.33 ml / min. Conclusions: The main cause of acute kidney injury regardless of the age group was dehydration. Due to the high percentage of AKI in the elderly, this group requires more preventive action, not only in the hospital but also at home.

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Effect of mobile guided cardiac rehabilitation on quality of life – the EU-CaRE randomised clinical trial

European Heart Journal ◽

10.1093/ehjci/ehaa946.3105 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

V Houben ◽

J.A Snoek ◽

E Prescott ◽

N Mikkelsen ◽

A.E Van Der Velde ◽

...

Keyword(s):

Quality Of Life ◽

Elderly Patients ◽

Cardiac Rehabilitation ◽

Control Group ◽

Funding Source ◽

Multi Centre Study ◽

Old Patients ◽

Home Based ◽

Significant Difference

Abstract Background and purpose Although participation in cardiac rehabilitation (CR) improves quality of life (QoL), participation in CR, especially among elderly, is limited. We conducted this study to assess whether mobile home-based CR (mCR) increases QoL in elderly (≥65 years old) patients with coronary artery disease (CAD) or a valvular intervention who decline participation in conventional CR. Methods It is designed as a randomised multi-centre study with two parallel arms. Randomisation assigned patients either to mCR or a control group. mCR Consisted of six months of home-based CR with telemonitoring and coaching. Control-group patients did not receive any form of CR throughout the study period. Quality of life was measured with the SF-36v2 questionnaire at 0, 6 and 12 months. Results A total of 179 patients were included in this study (90 control, 89 mCR). A flowchart of the trial is presented in Figure 1. Patients were predominantly male (81.1%). Baseline characteristics can be found in Table 1. Patients using mCR improved on physical QoL after 6 (p=0.026) and 12 (p=0.008) months. There was no difference on mental QoL for both groups (mCR 6 months p=0.563, 12 months p=0.945; control 6 months p=0.589, 12 months p=0.542). No difference existed in QoL between the mCR and control group (physical: 6 months p=0.070, 12 months p=0.150; mental: 6 months p=0.355, 12 months p=0.625). Conclusion Although there is no significant difference in QoL between the control and mCR group, mCR increases physical QoL after 6 and 12 months in elderly patients who decline participation in conventional CR. Therefore E-Health tools should be considered as an alternative for conventional CR when (elderly) patients decline to participate in conventional CR. Figure 1. Flow chart of all eligible patients Funding Acknowledgement Type of funding source: Public grant(s) – EU funding. Main funding source(s): European Union's Horizon 2020 research and innovation programme

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The Severity of Fatigue Among Bone Marrow Transplantation Patients

Journal of Global Oncology ◽

10.1200/jgo.18.10200 ◽

2018 ◽

Vol 4 (Supplement 2) ◽

pp. 99s-99s

Author(s):

O. Abdalrahman ◽

E. Almashaikh ◽

H. Aljarrah

Keyword(s):

Quality Of Life ◽

Bone Marrow ◽

Bone Marrow Transplantation ◽

Cancer Patients ◽

Subscale Score ◽

Medical Intervention ◽

Significant Difference ◽

Fatigue Severity ◽

Male Patients

Background: Fatigue interferes with the individual´s functioning and quality of life in cancer patients specifically, after chemotherapy and post–bone marrow transplantation (BMT), fatigue is not adequately addressed and prioritized among health care providers. Aim: The purpose of this study is to determine the severity and prevalence of fatigue among cancer patients post-BMT after receiving chemotherapy. Methods: A descriptive, cross-sectional and correlational design was used, Piper fatigue scale (PFS) Arabic version was used to measure participants' level of fatigue, the scale measures four dimensions of subjective fatigue: behavioral, affective, sensory, and cognitive. Patients above 18 years old, received chemotherapy and do BMT between Oct 2016 and Oct 2017, were included in this study. Results: 100 patient participated in this study, 52% (N: 52) diagnosed with leukemia, 32% (N: 32) lymphoma, and 16% (N: 16) hematology. Thirty-nine patients (39%) had no or mild fatigue level, they do not need medical intervention, 47% (N: 47) and 14% (N: 14) classified as moderate and sever level of fatigue respectively, equal to 61% of the total sample who need medical intervention. Overall fatigue severity categories; mild, moderate, and sever shows that there is significant difference in term of severity subscale in sensory and behavioral dimensions ( P = 0.03, 0.004) respectively, and the other subscale dimension did not significantly differ among patient ( P > 0.05), the highest mean subscale score occurred in the behavioral dimension (M = 4.8, SD = 2.37), while the lowest mean subscale score occurred in cognitive dimension, (M=2.59, SD=2.35). The overall score mean of the male patients regarding the fatigue severity was 45.18 (n=74), and for the female patients the mean was 57.03 (n=26), and the result shows that there was significant difference in the overall mean scores between male patients and female patients (t (98)= −2.2, P < 0.05). Conclusion: Fatigue-related to BMT is a serious and prevalent problem among patients with cancer. Fatigue may impair quality of life among this group of patients; further study may be conducted to assess the effect of fatigue on quality of life and activity of daily living. It is essential to include fatigue assessment as a priority for the BMT patients.

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Kidney Transplant in an Old Woman-A Case Report and Review of the Literature

BANTAO Journal ◽

10.2478/bj-2014-0013 ◽

2015 ◽

Vol 12 (1) ◽

pp. 62-64

Author(s):

Lidija Orlic ◽

Ivana Mikolasevic ◽

Branka Sladoje-Martinovic ◽

Ivan Bubic and Sanjin Racki

Keyword(s):

Quality Of Life ◽

Renal Transplantation ◽

Elderly Patients ◽

End Stage Renal Disease ◽

Older Patients ◽

Review Of The Literature ◽

Stage Renal Disease ◽

End Stage ◽

Esrd Patients

Abstract The number of elderly patients with chronic kidney disease (CKD) as well as those with end-stage renal disease (ESRD) are increasing worldwide. Renal transplantation is now the treatment of choice for all ESRD patients, including those that are aged 65 or over. Namely, there is a growing evidence that elderly patients, in the absence of contraindications, have better outcomes after renal transplantation than alternative forms of RRT. Although survival, quality of life and economic advantages have been shown after transplantation, renal transplantation is still infrequently offered to older patients. Hereby, we present a case of an old woman who was transplanted in 1994 when “senior” program was still not established and when kidney transplantation at this age was rarity in many countries. She lived 16 years and 8 months with a well-functioning graft and died at the age of 89.

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Abstract 17469: Comparing the Effect of CRT Implantation on Quality of Life in Older Patients Compared With Younger Patients: Systematic Review and Meta-Analysis

Circulation ◽

10.1161/circ.142.suppl_3.17469 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Praveen Ponnamreddy ◽

Saeed Juggan ◽

Lauren Gilstrap

Keyword(s):

Quality Of Life ◽

Older Patients ◽

Meta Analysis ◽

Nyha Class ◽

Age Group ◽

Walk Test ◽

Younger Patients ◽

Six Minute Walk Test ◽

Minute Walk

Background: CRT had been accepted as standard of care for patients with HFrEF who qualify for the therapy. The pivotal CRT trials enrolled patients significantly younger than the typical HFrEF patients seen in the community. Benefits of CRT in older HFrEF patients is largely unknown. We sought to evaluate the change in quality of life in older patients undergoing CRT in comparison to younger patients. Hypothesis: CRT implantation is associated with comparable improvements in quality of life in younger patients (age <70) and older patients (age 70 and above). Methods: PubMed, The Cochrane Library, Scopus, and Web of Science were queried for comparative effectiveness studies of CRT in older HFrEF patients. We gathered data for Quality of life measurements including improvement in NYHA class, MLHFQ, Six minute walk test. MLHFQ, Six minute walk test data was analyzed qualitatively as data was insufficient to impute Standard deviation for mean change. Changes in NYHA class was analyzed quantitatively. Random effects meta-analysis of improvement in NYHA class and relative risk (RR) is reported along with estimates of heterogeneity Results: Seven studies [n=2494 for younger group and n=1035 for older group] were included in changes in NYHA class meta-analysis. Older age group patients had similar improvement in NYHA class compared to younger age group patients. Relative risk 0.99 with 95%CI 0.93-1.06 (figure). Five studies reported Baseline and follow up MLHFQ scores for both the groups. All the five studies reported improvements in MLHFQ in both the groups. Three studies reported change in six minute walk test in meters before and after CRT implantation. All the studies reported improvement in six minute walk test both in younger and older group. Conclusions: People older than 70 years of age with heart failure with reduced ejection fraction who qualify for CRT derive similar benefits with improvement in quality of life compared to patients aged less than 70 years of age.

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