Cherifi Francois, Gernier François, Jardin Fabrice, Lefevre-Arbogast Sophie, Bastien Etienne, Lequesne Justine, Rigal Olivier, Quilan Florian, Clarisse Bénédicte, Grellard Jean-Michel, Binarelli Giulia, Fernette Marie, Lange Marie, Richard Doriane, Morel Adeline, Griffon Bénédicte, Pepin Louis-Ferdinand, Leconte Alexandra, Faveyrial Audrey, Leheurteur Marianne, Beauplet Bérengère, Joly Florence
Medical Oncology Department, Centre Francois Baclesse, UNICANCER, Caen 14076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France.
Clinical Research Department, Centre Francois Baclesse, UNICANCER, Caen 14 076, France; Normandie University, UniCaen, INSERM U1086 "ANTICIPE" (Interdisciplinary Research Unit for Cancers Prevention and Treatment), Caen 14076, France.
J Geriatr Oncol. 2023 Nov;14(8):101634. doi: 10.1016/j.jgo.2023.101634. Epub 2023 Sep 25.
The Coronavirus (COVID-19) pandemic and its associated health restrictions have harmed the population psychologically. We aimed to compare the post-traumatic stress disorder (PTSD) symptoms and Quality of Life (QoL) in older French patients with cancer to the younger ones.
This longitudinal multicenter study named COVIPACT began in April 2020 during the first French lockdown and has included 579 outpatients receiving treatment for a solid or hematological malignancy. Data were collected every three months, namely at the first release period (M3), at the second lockdown (M6), at the second release period (M9), and finally at the last curfew period (M12) in France. Standardized validated self-questionnaires were used to assess PTSD symptoms (using the Event Scale-Revised self-questionnaire), insomnia (through the Insomnia Severity Index questionnaire), QoL (using the Functional Assessment of Cancer Therapy - General questionnaire), and cognitive complaints (through the Functional Assessment of Cancer Therapy - Cognition questionnaire). Student (or Wilcoxon) tests and Chi-squared tests were used for continuous or discrete variables, respectively. We conducted linear mixed model to study the change during follow-up.
Out of 579 included patients, 157 (27%) were ≥ 70 years old at baseline, of whom 104 participated in the longitudinal study. At baseline, older patients reported fewer PTSD symptoms (17% versus 23%, p = .06), insomnia (17% versus 27%, p = .02), and cognitive complaint (3% versus 16%, p < .01) than younger patients. QoL at baseline was similar between age subgroups. We observed no significant difference in the trajectory of PTSD symptoms, insomnia, or emotional well-being between both groups during the follow-up. Cognitive complaints were lower at baseline in older patients but steadily increased during the follow-up and reached the same level as younger patients at one year.
One in five older patients reported PTSD symptoms, evolving similarly to younger patients during the first year of the COVID-19 pandemic. While cognitive complaints tend to recover in a bell-shaped curve at one year in younger patients, the trend is increasing in older ones. Screening for PTSD symptoms and late cognitive impairment should be given special attention in older patients.
Clinicaltrials.gov identifier: NCT04366154.
冠状病毒（COVID-19）大流行及其相关的健康限制措施对民众的心理造成了伤害。我们旨在比较法国老年癌症患者与年轻癌症患者的创伤后应激障碍（PTSD）症状及生活质量（QoL）。
这项名为COVIPACT的纵向多中心研究于2020年4月法国首次封锁期间启动，纳入了579名正在接受实体瘤或血液系统恶性肿瘤治疗的门诊患者。每三个月收集一次数据，即在法国的第一个解封期（M3）、第二次封锁期（M6）、第二个解封期（M9），最后是在最后一次宵禁期（M12）。使用标准化的经过验证的自填问卷来评估PTSD症状（使用事件量表修订版自填问卷）、失眠（通过失眠严重程度指数问卷）、生活质量（使用癌症治疗功能评估 - 通用问卷）以及认知主诉（通过癌症治疗功能评估 - 认知问卷）。分别使用学生（或威尔科克森）检验和卡方检验来分析连续变量或离散变量。我们采用线性混合模型来研究随访期间的变化情况。
在纳入的579名患者中，157名（27%）在基线时年龄≥70岁，其中104名参与了纵向研究。在基线时，老年患者报告的PTSD症状（17%对23%，p = 0.06）、失眠（17%对27%，p = 0.02）和认知主诉（3%对16%，p < 0.01）均少于年轻患者。各年龄亚组在基线时的生活质量相似。在随访期间，我们观察到两组在PTSD症状、失眠或情绪健康轨迹方面没有显著差异。老年患者的认知主诉在基线时较低，但在随访期间稳步增加，到一年时达到与年轻患者相同的水平。
五分之一的老年患者报告有PTSD症状，在COVID-19大流行的第一年，其症状发展与年轻患者相似。虽然年轻患者的认知主诉在一年时倾向于呈钟形曲线恢复，但老年患者的趋势是上升的。应特别关注老年患者的PTSD症状筛查和晚期认知障碍。
Clinicaltrials.gov标识符：NCT04366154。
