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老年癌症幸存者与年轻癌症幸存者相比,抑郁、疼痛和疲劳的发生率及其预测因素。

Prevalence and predictors of depression, pain, and fatigue in older- versus younger-adult cancer survivors.

机构信息

Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Stony Brook University Medical Center, Stony Brook, NY, USA.

出版信息

Psychooncology. 2018 Mar;27(3):900-907. doi: 10.1002/pon.4605. Epub 2018 Jan 25.

Abstract

BACKGROUND

As the number of older adults in the United States continues to grow, there will be increasing demands on health care providers to address the needs of this population. Cancer is of particular importance, with over half of all cancer survivors older than 65 years. In addition, depression, pain, and fatigue are concerns for older adults with cancer and have been linked to poorer physical outcomes.

METHODS

For this retrospective chart review, 1012 eligible participants were identified via a query of the Electronic Medical Record for all patients referred to 1 of 4 Survivorship Clinics at Memorial Sloan Kettering Cancer Center. All patients were between the ages of 30 to 55 (younger adults) and >65 (older adults). Depression was measured using the Patient Health Questionnaire-9 (PHQ-9).

RESULTS

The overall rate of depression in this sample of adult cancer survivors was 9.3%. There were no differences in the rates of clinically significant depression (defined as PHQ-9 score ≥10) between younger and older adult cohorts. However, there was a small trend toward higher mean PHQ-9 scores in the younger adult cohort (3.42 vs 2.95; t = 1.763, P = .10). Women reported greater rates of depression and higher pain and fatigue scores. Hispanic/Latino patients also reported significantly greater rates of depression.

CONCLUSION

There were no observed differences in depression between older and younger adult cancer survivors. Gender and ethnic discrepancies in depression were observed. Future research should focus on understanding the nature of these differences and targeting interventions for the groups most vulnerable to depression after cancer treatment.

摘要

背景

随着美国老年人口数量的不断增加,医疗保健提供者将面临越来越多的需求,以满足这一人群的需求。癌症尤为重要,超过一半的癌症幸存者年龄在 65 岁以上。此外,抑郁、疼痛和疲劳是老年癌症患者关注的问题,并且与较差的身体结果有关。

方法

在这项回顾性图表审查中,通过对 Memorial Sloan Kettering 癌症中心的 4 个生存诊所之一的所有患者的电子病历进行查询,确定了 1012 名符合条件的参与者。所有患者的年龄均在 30 至 55 岁(年轻人)和>65 岁(老年人)之间。使用患者健康问卷-9(PHQ-9)测量抑郁情况。

结果

在该成年癌症幸存者样本中,抑郁的总体发生率为 9.3%。年轻和老年成人队列之间,临床显著抑郁(定义为 PHQ-9 评分≥10)的发生率没有差异。然而,年轻成人队列的平均 PHQ-9 评分略高(3.42 对 2.95;t=1.763,P=0.10)。女性报告的抑郁率更高,疼痛和疲劳评分也更高。西班牙裔/拉丁裔患者的抑郁率也显著更高。

结论

在老年和年轻成年癌症幸存者中,抑郁无明显差异。在抑郁方面存在性别和种族差异。未来的研究应集中于了解这些差异的性质,并针对癌症治疗后最易患抑郁症的群体进行干预。

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