Massa Elena, Donisi Clelia, Liscia Nicole, Madeddu Clelia, Impera Valentino, Mariani Stefano, Scartozzi Mario, Lai Eleonora
Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Clin Pract Epidemiol Ment Health. 2021 Dec 31;17(1):295-306. doi: 10.2174/1745017902117010295. eCollection 2021.
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.
The main goal of this article is to review the literature from the past 20 years on the relationships between depression, cancer, and aging.
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.
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.
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.
抑郁症是老年人和肿瘤患者中常见的精神问题。在患有癌症的老年人中，抑郁症具有独特的临床表现。它对生活质量有重大影响。此外，它与治疗依从性差、自杀风险增加和死亡率相关。然而，癌症老年患者的抑郁症话题仍未得到充分探索。
本文的主要目标是回顾过去20年中关于抑郁症、癌症和衰老之间关系的文献。
采用Prisma研究纳入标准模型。选择在文本或摘要中出现关键词“抑郁症”“癌症”“老年人、衰老或老年病”的文章。通过匹配关键词“抑郁症、老年人和癌症”，共识别出8056篇文章。只有532篇论文符合检索限制和筛选过程的纳入标准。在532篇论文中，467篇被认为不相关，剩下65篇相关研究。在65篇合适的研究中，39篇（60.0%）符合我们的质量标准并被纳入。
癌症老年患者抑郁症的相关危险因素可分为4组：1）肿瘤相关；2）抗癌治疗相关；3）患者相关；4）合并症的数量和类型。癌症老年患者抑郁症诊断的主要障碍在于癌症症状和治疗副作用与抑郁症症状的重叠，以及老年人报告抑郁症状的不同方式和抑郁症的不同临床类型。缺乏用于评估癌症老年患者抑郁症的有效量表数据。任何精神疾病，特别是同时出现的焦虑和抑郁，都会增加诊断延迟和抗癌治疗依从性的风险。癌症以及癌症诊断前的精神障碍诊断与自杀风险增加相关。非药物治疗方法、药物治疗和/或两者结合可用于治疗癌症老年患者，但必须详细分析合并症并评估多重用药情况，以避免潜在的副作用以及抗抑郁药与患者所服用的其他药物之间的相互作用。
未来的研究应以开发一种经过修改和调整的评估方法为目标，用于诊断和治疗癌症老年患者的抑郁症，以改善他们的临床结局和生活质量。
