Fatigue and functional dependence in older cancer patients.
OBJECTIVE
Functional dependence is a costly manifestation of aging that compromises the quality of life of elderly individuals and their caregivers. In this study, we hypothesized that fatigue may be a cause of functional dependence in older cancer patients. To establish whether fatigue was associated with dependence in 1 or more activities of daily living (ADLs) or instrumental activities of daily living (IADLs), and declining performance status (PS). In addition, we studied the prevalence of fatigue and its correlation with anemia, depression, and nutritional status.


METHODS
Retrospective cross-sectional study of 214 patients aged 70 and older were seen over a 3-month period by the Senior Adult Oncology Program of the H. Lee Moffitt Cancer Center in Tampa, FL. Each patient was screened with a questionnaire assessing ADLs, IADLs, PS, cognitive impairment, depression, and malnutrition. In addition, each patient underwent assessment of fatigue with the fatigue symptom inventory and a determination of complete blood counts and complete chemical panel.


RESULTS
Fatigue was reported by 81% of the patients. The interference score of fatigue seemed to be a mediator for dependencies in ADLs and IADLs (P < 0.001 and 0.001), and poorer PS (P < 0.001).


CONCLUSIONS
Fatigue is a common chronic problem for older cancer patients and may represent a major cause of functional dependence.
Division of Medical Oncology, S Paolo Hospital, University of Milan, Milan, Italy. andrea_luciani@email.it
Andrea
A
Luciani
Paul B
PB
Jacobsen
Martine
M
Extermann
Paolo
P
Foa
Desire
D
Marussi
Janine A
JA
Overcash
Lodovico
L
Balducci
D000203:Activities of Daily Living; D000368:Aged; D000740:Anemia / Q000503:physiopathology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000503:physiopathology*; D005221:Fatigue / Q000503:physiopathology*; D005260:Female; D015577:Geriatric Assessment; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D017567:Karnofsky Performance Status; D018655:Lymphocyte Count; D008297:Male; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires
D006454:Hemoglobins