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BACKGROUND: older people with cancer are at risk of complex and fluctuating health problems, but little is known about the extent to which their well-being changes in the last years of life.
OBJECTIVE: to examine changes in physical, psychological and social well-being in the last 5 years of life of older people with cancer.
DESIGN: prospective cohort study.
SETTING: Belgium, the Netherlands.
PARTICIPANTS: people with a new primary diagnosis of breast, prostate, lung or gastrointestinal cancer, aged ≥70 years, life expectancy >6 months, were recruited from nine hospitals. We analysed data of deceased patients.
METHODS: data were collected from participants around diagnosis, and after 6 months, 1, 3 and 5 years through structured questionnaires administered through interviews or as self-report. Outcomes were physical, emotional, social, role functioning (EORTC QLQ-C30), depressive symptoms (GDS-15), emotional and social loneliness (Loneliness Scale). We conducted linear mixed model analyses.
RESULTS: analysing 225 assessments from 107 deceased participants (assessments took place between 1,813 and 5 days before death), mean age at baseline 77 years (standard deviation: 5.2), we found statistically significant deterioration in physical functioning (b = 0,016 [95%confidence interval 0.009-0.023]), depressive symptoms (b = -0,001 [-0.002 to 0.000]) and role functioning (b = 0.014 [0.004-0.024]). Changes over time in emotional and social functioning and in social and emotional loneliness were smaller and statistically non-significant.
CONCLUSIONS: care towards the end of life for older people with cancer needs to put their social and psychological well-being at the centre, alongside physical needs. Future research should focus on understanding inter-individual variation in trajectories.
Bibliographical note© The Author(s) 2021. Published by Oxford University Press on behalf of the British Geriatrics Society.
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SRP4: Strategic Research Programme: End-of-life in cancer and non-cancer patients: public health, health services and clinical research. Addressing present and future challenges in palliative care.
Deliens, L., Cohen, J., Van den Block, L., Pardon, K., Deliens, L., Cohen, J., Van den Block, L., Chambaere, K., Bilsen, J., Deschepper, R., Rietjens, J. A. C., Sterckx, S., Theuns, P., Vander Stichele, R. & Mortier, F.
1/11/12 → 31/10/22