Goodwin J S, Hunt W C, Samet J M
Department of Medicine, University of Wisconsin School of Medicine, Milwaukee.
Arch Intern Med. 1991 Feb;151(2):366-70.
We assessed the functional status and social support networks of 799 men and women aged 65 years or older newly diagnosed with cancer and living in six New Mexico counties. Functional limitations included depending on others for transportation (33%) and mental incompetence or poor recent memory (42%). The percentage of patients with functional limitation increased sharply with increasing age. In a substantial number of patients there was also evidence for poor social support networks; 26.5% of subjects lived alone and 38.9% had no children living in the vicinity. In a multiple logistic regression analysis, the predictors of having a poor social support network included non-Hispanic white ethnicity, advanced age, low income, and being a recent migrant to the area. Subjects with functional limitations were more likely to have poor social support networks than subjects without such limitations. The deleterious combination of impaired functional status and a limited social support network may explain why elderly cancer patients are at increased risk for not receiving appropriate therapy. Given the potential complexities involving the evaluation and appropriate treatment of cancer, care must be taken to adequately assess functional status and support mechanisms of older patients, and to provide adequate support to ensure compliance with treatment.
我们评估了799名年龄在65岁及以上、新诊断出患有癌症且居住在新墨西哥州六个县的男性和女性的功能状况及社会支持网络。功能限制包括出行依赖他人（33%）以及精神不健全或近期记忆力差（42%）。功能受限患者的比例随着年龄增长而急剧上升。相当多的患者还存在社会支持网络不佳的情况；26.5%的受试者独自生活，38.9%的受试者附近没有子女居住。在多元逻辑回归分析中，社会支持网络不佳的预测因素包括非西班牙裔白人种族、高龄、低收入以及近期刚迁移至该地区。与没有功能限制的受试者相比，有功能限制的受试者更有可能拥有不佳的社会支持网络。功能状况受损与社会支持网络有限的有害组合，或许可以解释老年癌症患者未接受适当治疗风险增加的原因。鉴于癌症评估和适当治疗可能涉及的潜在复杂性，必须注意充分评估老年患者的功能状况和支持机制，并提供足够的支持以确保其遵循治疗。
