Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 May;12(4):599-604.
doi: 10.1016/j.jgo.2020.10.020. Epub 2020 Nov 4.

Depression among older adults with gastrointestinal malignancies

Richard C Godby  1 , Chen Dai  2 , Mustafa Al-Obaidi  2 , Smith Giri  3 , Crystal Young-Smith  4 , Kelly Kenzik  3 , Andrew M McDonald  5 , Ravi K Paluri  6 , Olumide B Gbolahan  6 , Smita Bhatia  5 , Grant R Williams  3
Affiliations

Depression among older adults with gastrointestinal malignancies

Richard C Godby et al. J Geriatr Oncol. 2021 May.

Abstract

Background: Depression among older adults with cancer is under recognized and under treated. This study characterizes the burden of depression in older adults with gastrointestinal (GI) malignancies prior to chemotherapy and its relationship with geriatric assessment (GA) domains, health-related quality of life (HRQOL), and self-reported healthcare utilization.

Methods: Patients ≥60 years in GI oncology clinics at UAB were asked to complete a GA entitled the Cancer & Aging Resilience Evaluation (CARE). We examined depression using the Patient-Reported Outcomes Measurement Information System (PROMIS®) Depression four-item short form; moderate/severe depression was defined by a t-score ≥ 60. Multivariate analysis was used to examine associations between those with and without moderate/severe depression.

Results: Of 355 included patients, 46 had mild depression (13%) and an additional 46 patients had moderate/severe depression (13%). After adjustment for age, sex, education, cancer type, and cancer stage, those who reported moderate/severe depression had a significantly increased odds of reporting falls (adjusted odds ratio [aOR] 4.01, 95% confidence interval [CI] 1.94-8.26), dependence in IADLs (aOR 7.06,CI 2.91-17.1), dependence in ADLs (aOR 6.23, CI 2.89-13.4), malnutrition (aOR 5.86, CI 2.40-14.3), frailty (aOR 13.7, CI 5.80-32.1), and fatigue (aOR 11.2, CI 3.31-37.6). Moderate/severe depression was also significantly associated with worse physical (aOR 7.58, CI 3.30-17.4) and mental (aOR 26.3, CI 10.1-68.8) HRQOL sub-scores, without significant differences in healthcare utilization.

Conclusions: More than one out of eight older adults with a GI malignancy reported moderate/severe depression prior to chemotherapy, which was associated with impairments in several GA domains and HRQOL.

Keywords: Cancer and aging; Depression; Gastrointestinal malignancies; Geriatric oncology; Mental health; Patient-reported outcomes.

PubMed Disclaimer

Conflict of interest statement

Conflict-of-interest disclosure: The authors declare no competing financial interests.

Declaration of Competing Interests

The authors have no conflict to disclose.

Figures

Figure 1.
Figure 1.. Multifactorial and Resonant Interdependencies on Health in the Aging Cancer Population.
Abbreviation: HRQOL, health-related quality of life
Figure 2.
Figure 2.. Stratification of Depression.
The overall t-score mean was 48.5 (standard deviation 8.7). Out of the 355 patients analyzed, 46 (13%) reported mild depression and 46 (13%) reported moderate to severe depression.
See this image and copyright information in PMC

References

    1. Howlader N, Noone AM, Krapcho M, Miller D, Bishop K, Altekruse SF, Kosary CL, Yu M, Ruhl J, Tatalovich Z, Mariotto A, Lewis DR, Chen HS, Feuer EJCK. Cancer Statistics Review, 1975-2013 - SEER Statistics. SEER Cancer Stat Rev 1975-2013, Natl Cancer Institute; Bethesda, MD. 2015. https://seer.cancer.gov/archive/csr/1975_2016/. Accessed May 10, 2020.
    1. Smith BD, Smith GL, Hurria A, Hortobagyi GN, Buchholz TA. Future of Cancer Incidence in the United States: Burdens Upon an Aging, Changing Nation. J Clin Oncol. 2009;27(17):2758–2765. doi:10.1200/JCO.2008.20.8983 - DOI - PubMed
    1. Scher KS, Hurria A. Under-Representation of Older Adults in Cancer Registration Trials: Known Problem, Little Progress. J Clin Oncol. 2012;30(17):2036–2038. doi:10.1200/JCO.2012.41.6727 - DOI - PubMed
    1. CDC. Issue Brief No 1: What Do the Data Tell Us? The State of Mental Health and Aging in America. https://www.cdc.gov/aging/pdf/mental_health.pdf. Accessed May 10, 2020.
    1. CDC. Issue Brief No 2: Addressing Depression in Older Adults: Selected Evidence-Based Programs The State of Mental Health and Aging in America. In: CDC. ; 2014. http://www.gmhfonline.org/gmhf/consumer/depression.html. Accessed May 10, 2020.

Publication types

LinkOut - more resources