Disparity between the use of postoperative psychosocial and physical services among older adults with head and neck cancer.

e24016 Background: It is unclear whether older adults undergoing head and neck cancer (HNC) surgery have significant functional and mental health impairments perioperatively. We examined postoperative physical, nutritional and psychosocial service use among a cohort of older adults with HNC co-managed by geriatricians and surgeons. Methods: Our sample consisted of older adults who were referred to the Geriatrics Service at MSKCC between 2015-2019 and took a geriatric assessment (GA) prior to undergoing HNC surgery. Physical, nutritional and psychosocial service utilization during the patient’s stay was assessed. Physical services included a physical, occupational or rehabilitation consult. Nutritional services consisted of speech and swallow or nutritional consult. Psychosocial services consisted of a psychiatry, psychology, or social work consult. All patients were comanaged by geriatricians and surgeons. Relationships between each service use, all 12 geriatric deficits, demographic, and surgical characteristics were assessed using chi-squared analysis and t-test for continuous variables. Results: 159 patients (median age 81) were included. The median time in the OR was 342 min and the median length of stay (LOS) was 6 days. The most common GA impairments were major distress (61%), depression (59%), Social Activity Limitation (SAL) (53%) and deficits in Activities of Daily Living (ADL) (44%). Nutritional and physical services were used much more frequently than psychosocial services (79% and 85% vs 31%; p=.01 and p=.003, respectively). Lower ADL, increasing OR time and LOS were statistically associated with utilization of the three services and SAL was associated with a greater proportion of physical and psychosocial consults (Table). No demographic characteristics were associated with any of the services. Only 38% of patients with major distress and 40% of patients with depression had a mental health consult. In comparison, 93% of patients with an abnormal TUG had a physical consult and 92% of patients with weight loss greater than 10 pounds prior to surgery got a nutritional consult. Conclusions: Many older adults with head and neck cancer experience aging-related impairments. Physical impairments are more commonly addressed than psychosocial impairments. Future studies should aim to identify and overcome barriers to addressing psychosocial issues in HNC patients. [Table: see text]