title: Medical comorbidity and psychotropic medication fills in older adults with breast or prostate cancer.
abstract: BACKGROUND
  Previous research has shown that as people age, distress decreases despite an increase in prevalence of medical comorbidity. This could be due to increased use of psychotropic medications with comorbidity. We tested this hypothesis in older adults.
  
  
  METHODS
  Information from medical records of older adults (65 to 99 years of age) in the following groups was collected: women with breast cancer (n = 2359), women without any cancer diagnosis (n = 27,161), men with prostate cancer (n = 2686), and men without any cancer diagnosis (n = 21,014). We collected fills of antidepressant or sedative medications, diagnosis of depression in the year of cancer diagnosis, and Charlson Comorbidity Index from the year before cancer.
  
  
  RESULTS
  Women with breast cancer were more likely to fill psychotropic prescriptions (both ps < 0.02) or be diagnosed with depression (p < 0.001) than women without cancer. Men with prostate cancer were more likely to fill these prescriptions or receive a diagnosis of depression than men without cancer (ps < 0.05). Charlson was related to increased odds of filling both types of medication in women with breast cancer and men with prostate cancer (ps < 0.001). Comorbidity was related to greater odds of receiving a depression diagnosis in men with prostate cancer (p < 0.001) but not women with breast cancer (p > 0.15).
  
  
  CONCLUSIONS
  Older adults with breast or prostate cancer are more likely to fill psychotropic medication prescriptions and receive a depression diagnosis than those without cancer. Comorbidity increased the likelihood of medication fills in older adults with cancer. As this population experiences polypharmacy, nonpharmacologic treatments for depression may need to be considered.
authors.affiliation: Group Health Research Institute, 1730 Minor Ave #1600, Seattle, WA, 98101, USA, jones.s@ghc.org.
authors.forename: Salene M W
authors.initials: SM
authors.lastname: Jones
authors.forename: Dori
authors.initials: D
authors.lastname: Rosenberg
authors.forename: Evette
authors.initials: E
authors.lastname: Ludman
authors.forename: David
authors.initials: D
authors.lastname: Arterburn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy*; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy*; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D008297:Male; D019338:Polypharmacy; D011471:Prostatic Neoplasms / Q000150:complications / Q000188:drug therapy*; D011619:Psychotropic Drugs / Q000627:therapeutic use*
chemical_list: D000928:Antidepressive Agents; D011619:Psychotropic Drugs