Saracino Rebecca M, Cham Heining, Rosenfeld Barry, J Nelson Christian
Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Fordham University, Bronx, NY, USA.
Assessment. 2020 Oct;27(7):1383-1398. doi: 10.1177/1073191118784653. Epub 2018 Jun 27.
The aging of America will include a significant increase in the number of older patients with cancer, many of whom will experience significant depressive symptoms. Although geriatric depression is a well-studied construct, its symptom presentation in the context of cancer is less clear. Latent profile analysis was conducted on depressive symptoms in younger (40-64 years) and older (≥65 years) patients with cancer ( = 636). The sample was clinically heterogeneous (i.e., included all stages, dominated by advanced stage disease). Participants completed questionnaires including the Center for Epidemiological Studies Depression Scale, which was used for the latent profile analysis. A four-class pattern was supported for each age group. However, the four-class pattern was significantly different between the younger and older groups in terms of the item means within each corresponding latent class; differences were primarily driven by severity such that across classes, older adults endorsed milder symptoms. An unexpected measurement issue was uncovered regarding reverse-coded items, suggesting that they may generate unreliable scores on the Center for Epidemiological Studies Depression Scale for a significant subset of patients. The results indicate that cancer clinicians can expect to see depressive symptoms along a continuum of severity for patients of any age, with less severe symptoms among older patients.
美国人口老龄化将使老年癌症患者数量大幅增加,其中许多人会出现明显的抑郁症状。尽管老年抑郁症是一个经过充分研究的概念,但其在癌症背景下的症状表现尚不太明确。对年龄较轻(40 - 64岁)和年龄较大(≥65岁)的癌症患者(n = 636)的抑郁症状进行了潜在类别分析。该样本在临床上具有异质性(即涵盖所有阶段,以晚期疾病为主)。参与者完成了包括流行病学研究中心抑郁量表在内的问卷,该量表用于潜在类别分析。每个年龄组都支持一种四类模式。然而,在每个相应潜在类别中的项目均值方面,年轻组和老年组的四类模式存在显著差异;差异主要由严重程度驱动,即跨类别来看,老年人认可的症状较轻。关于反向计分项目发现了一个意外的测量问题,表明它们可能会在相当一部分患者的流行病学研究中心抑郁量表上产生不可靠的分数。结果表明,癌症临床医生可以预期任何年龄的患者都会出现不同严重程度的抑郁症状,老年患者的症状较轻。