The prevalence and correlates of fatigue in older cancer patients

Abstract

Purpose: to assess the prevalence and correlates of fatigue in cancer patients aged 60 and older during outpatient treatment with chemotherapy or pamidronate.

Patient and methods: seventy-seven consecutive cancer patients with different tumors age 60+ served by the senior adult oncology program of the H. Lee Moffitt Cancer Center, were enrolled in the study. Inclusion criteria were: (1) age >-60 years; (2) histological diagnosis of malignancy; (3) no major psychiatric or neurological disorder that could interfere with the competition of the measures; (4) ability to understand and to speak English. Assessment included cognition, function, depression and fatigue. The instruments included geriatric depression scale, mini mental state examination and fatigue symptom inventory. The study used a cross-sectional design.

Results: Fifty-six patients (72.7%) reported fatigue at the time of the assessment; seventy-six patients (99%) in the past week. Forty patients (52%) rated their average fatigue as greater than 5. Forty-two patients (54%) reported that they felt fatigue all seven days, for any part of the day in the week before the assessment. Sixty five (84%) patients rated fatigue as interfering with their general level of activity. The fatigue disruptiveness was higher for women than for man (P<0.007). Marital status and educational level were not significantly related to fatigue severity or fatigue disruptiveness (P> or =0.33). A significant positive correlation between depressive symptoms and fatigue severity (r = 0.29, P<0.01) was recorded. Depression was also significantly related to fatigue disruptiveness (r = 0.44, P<0.01). Cognitive status was not correlated with fatigue severity or fatigue disruptiveness. A negative correlation between haemoglobin level and fatigue severity (r = -0.30, P<0.01) and between haemoglobin level and fatigue disruptiveness (r = -0.28, P<0.01) was found. Having had medical care or counselling in the past for anxiety and depression was positively correlated with fatigue disruptiveness (r = 0.29, P<0.01).

Conclusion: Fatigue is a common symptom of older cancer patients treated with antineoplastic medical treatment. Female patient showed higher fatigue disruptiveness than male. In this study a positive correlation between depression and fatigue, and a negative correlation between haemoglobin and fatigue, were recorded.