Division of Health Sciences, School of Health and Rehabilitation Sciences, College of Medicine, The Ohio State University, Columbus, Ohio, USA.
Center for Biostatistics, Department of Biomedical Informatics, The Ohio State University, Columbus, Ohio, USA.
J Women Aging. 2024 Sep-Oct;36(5):398-409. doi: 10.1080/08952841.2024.2357865. Epub 2024 Jun 3.
Despite frequent reports of mental health needs among older women with cancer, depressive symptoms often go unrecognized and untreated, particularly in socially vulnerable survivors. Here, we examined associations of sociodemographic factors and social limitations with depressive symptoms from pre-diagnosis to post-diagnosis in older women diagnosed with breast or gynecological cancer. Using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey (SEER-MHOS) linked dataset, we used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between sociodemographic factors (race, ethnicity, marital status, rurality) and social limitations (i.e., health interfering with social activities) on depressive symptoms in women aged ≥65 years with breast or gynecologic cancer ( = 1,353). Most participants had breast cancer (82.0%), stage I-II cancer (85.8%), received surgery for their cancer (94.8%), and radiation treatment (50.6%). Prior to diagnosis, 11.8% reported depressive symptoms, which nearly doubled to 22.4% at follow-up. Participants were 2.7 times more likely of reporting depressive symptoms after cancer diagnosis compared with pre-cancer diagnosis (95%CI: 2.10-3.48). Race, ethnicity, rurality, marital status, and social interference were significantly associated with an increased risk of depressive symptoms after cancer diagnosis than before their cancer diagnosis ( < 0.05). In summary, depressive symptoms increased following a cancer diagnosis. Our results suggest potential avenues for intervention that could lead to reduced depressive symptoms among older female cancer survivors.
尽管经常有报道称老年女性癌症患者存在心理健康需求，但抑郁症状往往未被识别和治疗，尤其是在社会弱势群体中。在这里，我们研究了社会人口因素和社会限制与被诊断患有乳腺癌或妇科癌症的老年女性从诊断前到诊断后的抑郁症状之间的关联。使用监测、流行病学和最终结果-医疗保险健康结果调查 (SEER-MHOS) 链接数据集，我们使用逻辑回归来估计优势比 (OR) 和 95%置信区间 (CI)，以评估社会人口因素（种族、族裔、婚姻状况、农村地区）和社会限制（即健康干扰社会活动）与≥65 岁女性的抑郁症状之间的关联，这些女性患有乳腺癌或妇科癌症（n=1353）。大多数参与者患有乳腺癌（82.0%），癌症处于 I-II 期（85.8%），接受了癌症手术（94.8%）和放射治疗（50.6%）。在诊断之前，有 11.8%的人报告有抑郁症状，在随访中几乎翻了一番，达到 22.4%。与癌症诊断前相比，参与者在癌症诊断后报告抑郁症状的可能性增加了 2.7 倍（95%CI：2.10-3.48）。种族、族裔、农村地区、婚姻状况和社会干扰与癌症诊断后比诊断前发生抑郁症状的风险增加显著相关（<0.05）。总之，癌症诊断后抑郁症状增加。我们的研究结果表明了干预的潜在途径，这可能会减少老年女性癌症幸存者的抑郁症状。
