Abstract
Introduction
Psychosocial status contributes to overall quality of life (QOL) for patients with
cancer as psychosocial distress is commonly seen in this population. We sought to describe the psychosocial needs of older adults with metastatic breast
cancer (MBC) treated in the community. We evaluated the correlation between the patient's
psychosocial status and the presence of other geriatric abnormalities in this patient
population.
Materials and Methods
This is a secondary analysis of a completed study evaluating older adults (≥65 years)
with MBC treated at community practices who received a geriatric assessment (GA).
This analysis evaluated psychosocial factors collected during GA, including depression
assessed by Geriatric Depression Scale (GDS), perceived social support (SS) assessed
by Medical Outcomes Study Social Support Survey (MOS), and objective social supportassessed
by demographic variables (living situation and marital status). Perceived SS was further
subdivided into tangible social support (TSS) and emotional social support (ESS).
Kruskal-Wallis tests, Wilcoxon tests, and Spearman's correlations were used to assess
the relationship between psychosocial factors, patient characteristics, and geriatric
abnormalities.
Results
One hundred older patients with MBC were enrolled and completed GA with a median age
of 73 years (65–90). Almost half of the participants (47%) were either single, divorced,
or widowed and 38% lived alone, demonstrating a significant number of patients with
objective social support deficits. Patients with HER2+ or triple negative MBC had
lower overall SS scores compared to patients with ER/PR+ or HER2- MBC (p = 0.033). Patients on fourth line of therapy were more likely to screen positive
for depression compared to patients on earlier lines of therapy (p = 0.047). About half (51%) of the patients indicated at least one SS deficit on the
MOS. A higher GDS and lower MOS score correlated with greater total GA abnormalities
(p = 0.016). Evidence of depression correlated with poor functional status, decreased
cognition, and a high number of co-morbidities (p < 0.005). Abnormalities in functional status, cognition, and high GDS are associated
with lower ESS (p = 0.025,0.031,0.006 respectively).
Discussion
Psychosocial deficits are common among older adults with MBC treated in the community
and are associated with the presence of other geriatric abnormalities. These deficits
require a thorough evaluation and management to optimize treatment outcomes.
Keywords
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Article info
Publication history
Published online: February 15, 2023
Accepted:
January 30,
2023
Received in revised form:
November 10,
2022
Received:
August 20,
2022
Identification
Copyright
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