Originally published as JCO Early Release 10.1200/JCO.2008.19.9463 on August 3 2009

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Google Scholar Articles by Hurria, A. Articles by Kelly, E. PubMed PubMed Citation Articles by Hurria, A. Articles by Kelly, E. Social Bookmarking                            What's this?

Distress in Older Patients With Cancer

From the City of Hope, Duarte, CA; Weill Medical College of Cornell University; Memorial Sloan-Kettering Cancer Center, New York; Long Island Jewish Hospital, Long Island, NY; and Case Western Reserve University, Cleveland, OH.

Corresponding author: Arti Hurria, MD, Cancer and Aging Research Program, City of Hope, 1500 E Duarte Rd, Duarte, CA 91001; ahurria{at}coh.org.

Purpose To determine the predictors of distress in older patients with cancer.

Patients and Methods Patients age 65 years with a solid tumor or lymphoma completed a questionnaire that addressed these geriatric assessment domains: functional status, comorbidity, psychological state, nutritional status, and social support. Patients self-rated their level of distress on a scale of zero to 10 using a validated screening tool called the Distress Thermometer. The relationship between distress and geriatric assessment scores was examined.

Results The geriatric assessment questionnaire was completed by 245 patients (mean age, 76 years; standard deviation [SD], 7 years; range, 65 to 95 years) with cancer (36% stage IV; 71% female). Of these, 87% also completed the Distress Thermometer, with 41% (n = 87) reporting a distress score of 4 on a scale of zero to 10 (mean score, 3; SD, 3; range, zero to 10). Bivariate analyses demonstrated an association between higher distress ( 4) and poorer physical function, increased comorbid medical conditions, poor eyesight, inability to complete the questionnaire alone, and requiring more time to complete the questionnaire. In a multivariate regression model based on the significant bivariate findings, poorer physical function (increased need for assistance with instrumental activities of daily living [P = .015] and lower physical function score on the Medical Outcomes Survey [P = .018]) correlated significantly with a higher distress score.

Conclusion Significant distress was identified in 41% of older patients with cancer. Poorer physical function was the best predictor of distress. Further studies are needed to determine whether interventions that improve or assist with physical functioning can help to decrease distress in older adults with cancer.

Supported by a Paul Beeson Career Development Award in Aging Research (K23 AG026749-01; A.H.) and the American Society of Clinical Oncology Association of Specialty Professors Junior Development Award in Geriatric Oncology.

Authors' disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?