scholarly journals The Difficult Task of Diagnosing Depression in Elderly People with Cancer: A Systematic Review

2021 ◽  
Vol 17 (1) ◽  
pp. 295-306
Author(s):  
Elena Massa ◽  
Clelia Donisi ◽  
Nicole Liscia ◽  
Clelia Madeddu ◽  
Valentino Impera ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Elderly Patients ◽  
Elderly People ◽  
Diagnosis Delay ◽  
Keywords Depression ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Anticancer Treatment

Background: Depression is a common psychiatric problem in the elderly and oncology patients. In elderly people with cancer, depression has a peculiar phenomenology. It has a significant impact on the quality of life. Moreover, it is associated with poor adherence to treatments, increased risk of suicide, and mortality. Nevertheless, the topic of depression in elderly people with cancer remains unexplored. Objective: The main goal of this article is to review the literature from the past 20 years on the relationships between depression, cancer, and aging. Methods: The methods followed the Prisma model for eligibility of studies. The articles in which the keywords “depression”, “cancer”, “ elderly, aging, or geriatric” were present, either in the text or in the abstract, were selected. 8.056 articles, by matching the keywords “depression and elderly and cancer,” were identified. Only 532 papers met the eligibility criteria of search limits and selection process. Out of 532 papers, 467 were considered irrelevant, leaving 65 relevant studies. Out of 65 suitable studies, 39 (60.0%) met our quality criteria and were included. Results: The risk factors associated with depression in elderly people with cancer can be divided into 4 groups: 1) tumor-related; 2) anticancer treatment-related; 3) patients-related; 4) number and type of comorbidity. The main obstacles in diagnosing depression in elderly patients with cancer are the overlap of the symptoms of cancer and side effects of treatment with the symptoms of depression but also the different ways of reporting depressive symptoms of elderly people and the different clinical types of depression. There is a lack of data regarding validated scales to assess depression in geriatric patients with cancer. Any mental illness, specifically co-occurring anxiety and depression, increases the risk of diagnosis delay and anticancer treatment adherence. Cancer and the diagnosis of mental disorders prior to cancer diagnosis correlate with an increased risk for suicide. A non-pharmacological therapeutic approach, pharmacological treatment and/or a combination of both can be used to treat elderly patients with cancer, but a detailed analysis of comorbidities and the assessment of polypharmacy is mandatory in order to avoid potential side-effects and interactions between antidepressants and the other drugs taken by the patients. Conclusion: Future research should be conducted with the aim of developing a modified and adapted assessment method for the diagnosis and treatment of depression in elderly people with cancer in order to improve their clinical outcomes and quality of life.

Age, cancer site and gender associations with symptoms and problems in specialised palliative care: a large, nationwide, register-based study

2019 ◽  
pp. bmjspcare-2019-001880 ◽  
Author(s):  
Maiken Bang Hansen ◽  
Lone Ross ◽  
Morten Aagaard Petersen ◽  
Mogens Groenvold
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Physical Function ◽  
Cancer Diagnosis ◽  
Poor Quality ◽  
Cancer Site ◽  
Patients With Cancer ◽  
Increased Risk ◽  
And Gender

BackgroundPatients referred to specialised palliative care are troubled by symptoms/problems, but more knowledge is needed on the level and frequency of symptoms/problems. It is also uncertain how gender, age and cancer diagnosis, respectively, are associated with symptoms/problems.AimsTo describe symptoms/problems in patients with cancer at the start of specialised palliative care, and to study how age, gender and cancer diagnosis were associated with symptoms/problems.DesignA register-based study including data from the Danish Palliative Care Database.Setting/ParticipantsPatients with cancer who reported their symptoms/problems using the European Organisation for Research and Treatment of Cancer Quality of Life Questionaire-Core-15-Palliative Care (EORTC QLQ-C15-PAL) at the start of specialised palliative care were included. Ordinal logistic regression was performed to test if gender, age and cancer diagnosis were associated with each symptom/problem.Results31 771 patients with cancer were included in the study. The most prevalent and severe symptoms/problems were pain, appetite loss, fatigue, poor physical function and poor quality of life. Gender, age and cancer diagnosis were significantly associated with most symptoms/problems. The strongest associations between symptoms/problems and gender and age, respectively, were increased risk of nausea in women, as well as increased risk of poor physical function and reduced risk of sleeplessness and pain with increasing age. Patients with brain/central nervous system cancer had the lowest risk of symptoms but the highest risk of poor physical function.ConclusionAt the start of specialised palliative care, patients with cancer experience severe levels of symptoms, poor physical function and poor quality of life. Age, gender and diagnosis were significantly associated with most symptoms/problems, but the strength and direction of the associations differed across symptoms/problems.

Atypical Antipsychotics: Impact on Overall Health and Quality of Life

2002 ◽  
Vol 8 (4_suppl) ◽  
pp. S9-S17 ◽  
Author(s):  
Mary Ann Boyd
Keyword(s):  
Quality Of Life ◽  
Drug Therapy ◽  
Side Effects ◽  
Underlying Disease ◽  
Psychiatric Nurses ◽  
Increased Risk ◽  
Detailed Assessment ◽  
Concomitant Medications ◽  
Gait Disturbances

The use of antipsychotic medications for the treatment of schizophrenia requires a detailed assessment of patient history, including comorbidities and concomitant medications. Because all antipsychotics may produce a complex array of adverse effects, the patient’s drug therapy may lead to exacerbation of pre-existent health problems and impaired quality of life. The occurrence of drug-related side effects such as cardiac disturbances, diabetes, and obesity is important to document for these patients, especially if they are already at increased risk because of underlying disease, substance abuse, or smoking. Antipsychotics may also cause anticholinergic effects, gait disturbances, and excessive sedation, which are particularly important reactions to monitor in elderly patients. Psychiatric nurses need to be aware of the risk for these side effects in relation to patients’ new or ongoing medication so that potentially serious events can be recognized and corrected. Appropriate patient education about medication is also an important component in helping patients to recognize and manage side effects and to gain the most from their drug therapy.

The role of general surgery in the palliative care of patients with cancer

2015 ◽  
Author(s):  
Brian Badgwell ◽  
Robert S. Krouse
Keyword(s):  
Quality Of Life ◽  
Treatment Options ◽  
Symptom Control ◽  
Palliative Surgery ◽  
Common Symptom ◽  
Life Outcomes ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Patient Reported

Palliative surgery is defined as surgical intervention in patients with incurable malignancy for symptoms attributable to their cancer. A considerable percentage of consultations at major cancer centres are palliative in nature, resulting in 13-21% of all operations meeting the criteria for palliative surgery. Common symptom groups for evaluation include gastrointestinal obstruction, wound problems/infections, gastrointestinal bleeding, and obstructive jaundice. This chapter outlines the indications, treatment options, and outcomes for these diagnoses and a few less common indications for surgical consultation. Clinical trials are infrequent in this population and there is a paucity of prospective studies with quality of life outcomes measures. Most studies focus on morbidity and mortality as palliative surgery has long been recognized as having increased risk for complications, although recent studies suggest an improvement in this regard. The benefits of palliative surgery should focus on quality of life, symptom control, and symptom prevention. Future studies will be needed to determine the definitions of success and hopefully include patient-reported outcomes assessment.

scholarly journals Management of Cancer Therapy–Associated Oral Mucositis

2020 ◽  
Vol 16 (3) ◽  
pp. 103-109 ◽  
Author(s):  
Timothy J. Brown ◽  
Arjun Gupta
Keyword(s):  
Quality Of Life ◽  
Targeted Therapy ◽  
Systemic Infection ◽  
Anticancer Therapy ◽  
Oncologic Outcomes ◽  
Evidence Based ◽  
Patients With Cancer ◽  
Anticancer Treatment ◽  
Severe Mucositis

Mucositis is a common and feared complication of anticancer therapy that can affect up to 90% of certain populations of patients with cancer. Even seemingly uncomplicated mucositis, which is often self-limited, can result in intense patient discomfort and decline in quality of life. Severe mucositis can be complicated by uncontrolled pain, superinfection or systemic infection, bleeding, and dehydration, and severe mucositis can lead to interruptions or de-escalation in anticancer treatment, resulting in worse oncologic outcomes. This article provides an evidence-based summary to guide practicing oncologists in the assessment, prevention, and management of mucositis induced by chemotherapy, radiotherapy, and targeted therapy.

Quality of Life and Depression in Caregivers of Patients with Cancer

2017 ◽  
Vol 41 (S1) ◽  
pp. S653-S653
Author(s):  
I. Feki ◽  
S. Hentati ◽  
R. Sallemi ◽  
M. Moala ◽  
J. Masmoudi
Keyword(s):  
Quality Of Life ◽  
Elderly Patients ◽  
Short Form ◽  
University Hospital ◽  
Related Factors ◽  
Cross Sectional ◽  
Old Patients ◽  
Patients With Cancer ◽  
Sf 36

BackgroundMost elderly patients, with cancer are cared for, by a family member who may be affected by various stressors that can influence their health and quality of life (QOL).ObjectivesTo explore depression, quality of life and its related factors among caregivers of elderly patients with cancer.MethodologyThis is a descriptive and analytical cross-sectional study including 40 primary caregivers of old patients aged 65 or older, with cancer in oncologic radiotherapy service in university hospital Habib Bourguibain Sfax, Tunisia. The short form health survey (SF-36) and Beck inventory (13 items) were used to assess respectively QOL and depression.ResultsThe average age of caregivers was 44.62 years. The sex ratio (M/F) was 0.9. Most of caregivers (75%) had impaired QOL (score ˂ 66.7). The two main components of SF-36 were altered with a standard score of 45 for the physical component and 41.1 for mental component. According to Beck inventory, Depression was present in 67.6% of cases. Impaired QOL of life was significantly correlated with somatic illnesses in the caregiver (P = 0.016), advanced stage of cancer (P = 0.01), financial difficulties (P = 0.04), the non-cohabitation with the patient before the disease (P = 0.031) and depression (P = 0.00).ConclusionAccording to our study, caregiving can have a negative effect on the caregiver's mental and physical health. Assistance and information from healthcare professionals are the key to improving the ability of caregivers to cope with caring for older patients with cancer.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Prevalence and Prognostic Value of Malnutrition Among Elderly Cancer Patients Using Three Scoring Systems

2021 ◽  
Vol 8 ◽  
Author(s):  
Qi Zhang ◽  
Liang Qian ◽  
Tong Liu ◽  
Jia-Shan Ding ◽  
Xi Zhang ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nutritional Status ◽  
Elderly Patients ◽  
Scoring Systems ◽  
Assessment Tools ◽  
Life Questionnaire ◽  
Advanced Tumor Stage ◽  
Patients With Cancer ◽  
All Cause Mortality

Background: Malnutrition is common in patients with cancer and is associated with adverse outcomes, but few data exist in elderly patients. The aim of this study was to report the prevalence of malnutrition using three different scoring systems and to examine the possible clinical relationship and prognostic consequence of malnutrition in elderly patients with cancer.Methods: Nutritional status was assessed by using controlling nutritional status (CONUT), the prognostic nutritional index (PNI), and the nutritional risk index (NRI). Quality-of-life (Qol) was assessed during admission by using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30. Performance status (PS) was assessed by using the Eastern Cooperative Oncology Group (ECOG) classification. The relationship between nutritional status and overall survival and Qol were examined.Results: Data were available for 1,494 elderly patients with cancer (63.65% male), the mean age was 70.76 years. According to the CONUT, NRI, and PNI, 55.02, 58.70, and 11.65% patients were diagnosed with malnutrition, respectively. Worse nutritional status was related to older, lower BMI, lower hand grip strength, and more advanced tumor stage. All malnutrition indexes were correlated with each other (CONUT vs. PNI, r = −0.657; CONUT vs. NRI scores, r = −0.672; PNI vs. NRI scores, r = 0.716, all P < 0.001). During a median follow-up of 43.1 months, 692 (46.32%) patients died. For patients malnourished, the incidence rate (events-per-1,000person-years) was as follows: CONUT (254.18), PNI (429.91), and NRI (261.87). Malnutrition was associated with increased risk for all-cause mortality (adjust HR [95%CI] for CONUT: 1.09 [1.05–1.13], P < 0.001; PNI: 0.98[0.97–0.99], P < 0.001; NRI: 0.98 [0.98–0.99], P < 0.001). All malnutrition indexes improved the predictive ability of the TNM classification system for all-cause mortality. Deterioration of nutritional status was associated with deterioration in Qol parameters and immunotherapeutic response (P < 0.001).Conclusions: Malnutrition was prevalent in elderly patients with cancer, regardless of the assessment tools used, and associated with lower Qol and the immunotherapy response.

scholarly journals Symptoms, side-effects and senility (or, the health professional as a cause of dependency in old age)

1982 ◽  
Vol 38 (4) ◽  
pp. 89-90
Author(s):  
G. S. Watermeyer
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Health Professional ◽  
Elderly People ◽  
Old Age ◽  
Health Professions ◽  
The Elderly ◽  
Psychological Problems

Many elderly people develop a multiplicity of physical and psychological problems in association with advancing age. It has become possible for the health professions to do a great deal to limit the extent of disability and improve the symptomatology, thus improving quality of life. Massive advances have taken place in the field of pharmacology and therapeutics. Many of the medicines utilised have untoward side-effects in the elderly; side-effects which are frequently not recognised timeously. A few of the side-effects are discussed in some detail and pleas are made for the judicious application of therapeutic schedules to problems in the elderly, recognising the dangers inherent in multiple prescribing.

scholarly journals Evaluation of sarcopenia in long-lived elderly patients: comparison between the Muscle Mass Index and the Calf Circumference

2021 ◽  
Vol 100 (1) ◽  
pp. 94-95
Author(s):  
Isadora Cecília Salgado Gama ◽  
Sergio Chociay Junior ◽  
Mariana de Paula Santana ◽  
Nadine Motta Figueiredo ◽  
Nathália de Oliveira Andrade ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Skeletal Muscle ◽  
Elderly Patients ◽  
Elderly People ◽  
Muscle Mass ◽  
Skeletal Muscle Mass ◽  
The Elderly ◽  
Calf Circumference ◽  
Extreme Longevity

The increase in life expectancy, observed in several countries, including Brazil, is due to improvements in living and health conditions and the epidemiological transition from the causes of morbidity and mortality, from infectious and parasitic diseases to chronic diseases. Furthermore, an increase in longevity, in addition to advances in science, with the improvement of diagnoses and the search for new treatments contributed to the increase in years lived1,2. However, the aging process is associated with a decrease in organic functions over the years. Sarcopenia is considered a complex geriatric syndrome and is defined as an age-related decline in skeletal muscle mass and function2. It is a major public health concern because it can result in functional decline, disability, falls, increased hospitalization costs, poor quality of life, and even deaths3. Although Dual-energy X-ray Absorptiometry (DXA) is the most used method to estimate the loss of muscle mass4 the high cost and low viability hinder its use in Primary Health Care (PHC). Methods such as Muscle Mass Index (MMI) and Calf Circumference (CC) can be used replacing DXA due to ease of access and application as well as low cost5. The Academic League of Geriatrics and Gerontology, Três Lagoas Campus, Federal Univeristy of Mato Grosso do Sul designed and executed a research intending to evaluate several aspects in elderly people with extreme longevity. One of the variables analyzed was sarcopenia, which was evaluated and compared using MMI and CC. For this purpose, a cross-sectional and quantitative study was performed in 2019/2020, with n = 69 individuals aged ≥ 90 years, of both genders, users of the Unified Health System in the town of Três Lagoas – MS. A sociodemographic questionnaire containing gender, age, and years of schooling was applied. Anthropometric data (CC and MMI) were collected in triplicate. The skeletal muscle mass was determined using the formula of Lee and collaborators which considers age, body mass, gender, ethnicity and height5. The values of MMI ​​of Janssen and collaborators were used as a reference to classify whether the nonagenarian or centenarians were sarcopenic or not6. For CC, a cutoff score ≤ 31 centimeters was adopted as a sign of sarcopenia7. The interviewed elderly had an average age of 93.5 years old, 1.3 years of schooling and 52.2% of the participants were women. The average CC was 31.2 centimeters, with 46.1% being considered sarcopenic patients according to this parameter. The average MMI was 5.1 kg/m2, with 100% of the elderly patients being considered sarcopenic through this method. There was no relationship between CC and MMI (p = 0.213). The high rates of sarcopenia found, especially using MMI and the absence of a relationship between the CC and MMI highlights the need to use more reliable methods to evaluate sarcopenia in long-lived elderly people, since the identification from CC, despite being easy and fast, may not be sensitive in this age group. These findings also lead to considering the use of more specific methods or those associated with other variables, such as Timed up and Go (TUG), for the evaluation of sarcopenia in the elderly aged 90 years or over. Future investigations should  consider the importance of validating specific instruments for elderly people in extreme longevity, as they constitute a group that has unique characteristics. The screening, monitoring, and health promotion carried out by PHC teams can promote the improvement in the quality of life of elderly people in extreme longevity.

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