title: The relationship between age, anxiety, and depression in older adults with cancer.
abstract: OBJECTIVE
  In older men with prostate cancer, aging is associated with reduced anxiety and increased depression. The purpose of this study was to examine the association among age, anxiety, and depression in a cohort of older adults receiving chemotherapy.
  
  
  METHODS
  This is a secondary analysis of a prospective longitudinal study investigating chemotherapy toxicity in older adults with cancer. Baseline data (pre-chemotherapy) included: age, sociodemographics, tumor and treatment factors, functional status, comorbidities, psychological state (measured by the Hospital Anxiety and Depression Scale), and social support. Univariate and multiple regression analyses were conducted to test the relationship between age, anxiety, and depression.
  
  
  RESULTS
  The average age of the 500 patients (56% females) was 73.1. The majority had late stage disease: 22% Stage III and 61% stage IV. Clinically significant depression was reported in 12.6%. Clinically significant anxiety was reported in 20.9%. In univariate analyses, there was no association between anxiety and age, or depression and age. In multivariable analyses, older age (p=0.05) was associated with decreased anxiety, as well as lack of social support (p<0.01) and increased number of comorbidities (p<0.01). In multivariable analysis, depression was associated with lack of social support (p<0.01), increased number of comorbidities (p<0.01), and advanced stage (p<0.01).
  
  
  CONCLUSIONS
  This study supports previous research that anxiety decreases with age in older adults with cancer. However, depression remained constant with increasing age. Greater resources and attention to identifying and treating the psychological sequelae of cancer in older adults are warranted.
authors.affiliation: Payne Whitney Manhattan, NewYork-Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA.
authors.forename: Talia R
authors.initials: TR
authors.lastname: Weiss Wiesel
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Christian J
authors.initials: CJ
authors.lastname: Nelson
authors.affiliation: Memorial Sloan Kettering Cancer Center, Gynecologic Medical Oncology Service, New York, NY, USA.
authors.forename: William P
authors.initials: WP
authors.lastname: Tew
authors.affiliation: City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
authors.forename: Molly
authors.initials: M
authors.lastname: Hardt
authors.affiliation: University of Rochester James P. Wilmot Cancer Center, Rochester, NY, USA.
authors.forename: Supriya Gupta
authors.initials: SG
authors.lastname: Mohile
authors.affiliation: Case Western Reserve University School of Medicine and Case Comprehensive Cancer Center, Cleveland, OH, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owusu
authors.affiliation: Wake Forest School of Medicine, Winston-Salem, NC, USA.
authors.forename: Heidi D
authors.initials: HD
authors.lastname: Klepin
authors.affiliation: Cancer Outcomes Public Policy and Effectiveness Research (COPPER) Center, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Cary P
authors.initials: CP
authors.lastname: Gross
authors.affiliation: Upstate Medical University and VA Medical Center, Syracuse, NY, USA.
authors.forename: Ajeet
authors.initials: A
authors.lastname: Gajra
authors.affiliation: Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: Stuart M
authors.initials: SM
authors.lastname: Lichtman
authors.affiliation: City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
authors.forename: Rupal
authors.initials: R
authors.lastname: Ramani
authors.affiliation: City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
authors.forename: Vani
authors.initials: V
authors.lastname: Katheria
authors.affiliation: City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Zavala
authors.affiliation: City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009369:Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000523:psychology*; D011446:Prospective Studies; D012944:Social Support
keywords: anxiety; cancer; depression; geriatric; older adults; oncology
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