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老年癌症患者中看不见的斗争——抑郁症及相关因素

The unseen struggle-depression and associated factors in geriatric cancer patients.

作者信息

Dogan Ozlem, Sahinli Hayriye, Yazilitas Dogan, Kantarci Selen

机构信息

Department of Medical Oncology, Adiyaman University Training and Research Hospital, Adıyaman, Türkiye.

Department of Medical Oncology, Ankara Etlik City Hospital, Ankara, Türkiye.

出版信息

Front Med (Lausanne). 2025 Jul 24;12:1603515. doi: 10.3389/fmed.2025.1603515. eCollection 2025.

Abstract

BACKGROUND

The objective of this study was to investigate the frequency of depression and its associations, rather than causal relationships, in patients aged 65 years and older receiving chemotherapy, using the Geriatric Depression Scale (GDS).

METHODS

This prospective study was conducted between January 2023 and December 2023 at Ankara Etlik City Hospital, including 501 chemotherapy patients aged 65 years and older. Patients receiving only oral therapy, those under palliative care, those with brain metastases, or those with insufficient cognitive functionality were excluded. Demographic and clinical data were collected from medical records. Depression was assessed using the 15-item Yesavage Geriatric Depression Scale (GDS), with scores ≥5 indicating high depression symptoms.

RESULTS

Among the 501 patients included in the study, 204 (40.7%) were female, with a median age of 69 years (range: 65-84 years). A total of 214 patients (42.7%) had high depressive symptom scores (GDS ≥ 5). A multivariable logistic regression analysis identified the following as independent predictors of depression: being female (odds ratio (OR): 1.481, 95% confidence interval (CI): 1.011-2.168,  = 0.04), body mass index (BMI) ≥ 21 (OR: 1.665, 95% CI: 1.081-2.564,  = 0.02), higher pain scores (OR: 1.269, 95% CI: 1.122-1.436,  < 0.001), insomnia (OR: 1.626, 95% CI: 1.109-2.384,  = 0.01), and weak social support (OR: 2.004, 95% CI: 1.046-3.839,  = 0.03).

CONCLUSION

Our study highlights the high prevalence of depressive symptoms among geriatric cancer patients. In this population, early diagnosis and management of depression, with particular attention to independent risk factors such as pain and insomnia, as well as strengthening social support mechanisms, may be crucial for enhancing quality of life and improving treatment adherence.

摘要

背景

本研究的目的是使用老年抑郁量表(GDS)调查65岁及以上接受化疗患者的抑郁频率及其关联,而非因果关系。

方法

这项前瞻性研究于2023年1月至2023年12月在安卡拉埃特利克市立医院进行,纳入501名65岁及以上的化疗患者。仅接受口服治疗的患者、接受姑息治疗的患者、有脑转移的患者或认知功能不足的患者被排除。从病历中收集人口统计学和临床数据。使用15项Yesavage老年抑郁量表(GDS)评估抑郁情况,得分≥5表明存在高度抑郁症状。

结果

在纳入研究的501名患者中,204名(40.7%)为女性,中位年龄为69岁(范围:65 - 84岁)。共有214名患者(42.7%)有高度抑郁症状评分(GDS≥5)。多变量逻辑回归分析确定以下因素为抑郁的独立预测因素:女性(比值比(OR):1.481,95%置信区间(CI):1.011 - 2.168,P = 0.04)、体重指数(BMI)≥21(OR:1.665,95% CI:1.081 - 2.564,P = 0.02)、较高的疼痛评分(OR:1.269,95% CI:1.122 - 1.436,P < 0.001)、失眠(OR:1.626,95% CI:1.109 - 2.384,P = 0.01)以及社会支持薄弱(OR:2.004,95% CI:1.046 - 3.839,P = 0.03)。

结论

我们的研究突出了老年癌症患者中抑郁症状的高患病率。在这一人群中,早期诊断和管理抑郁,特别关注疼痛和失眠等独立危险因素,以及加强社会支持机制,对于提高生活质量和改善治疗依从性可能至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1c7a/12328295/746bb5c6bb39/fmed-12-1603515-g001.jpg

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