title: Geriatric assessment findings independently associated with clinical depression in 1092 older patients with cancer: the ELCAPA Cohort Study.
abstract: OBJECTIVE
  We aim to assess the prevalence and associated factors of clinical depression in older patients with cancer.
  
  
  METHODS
  We studied a prospective cohort of cancer patients aged ≥ 70 years and referred to geriatric oncology clinics between 2007 and 2012. A multidimensional geriatric assessment was performed before choosing the cancer-treatment strategy. Clinical depression was diagnosed by senior geriatricians by a semi-structured interview. It encompassed criteria of the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) and of the International Classification of Diseases (10th edition). Multivariate logistic regression was performed.
  
  
  RESULTS
  Of 1121 consecutive patients, 1092 had available data (mean age, 80.4 years; women, 48.8%; metastases, 51.3%; cancer location: colorectal 21.1%, breast 16.8%, kidney, bladder or urinary tract 14.0%, and prostate 11.4%). The overall prevalence of clinical depression was 28.4% (95% confidence interval, 25.7-31.2). Factors independently associated with clinical depression by multivariate analysis adjusting for all following factors plus gender, and metastasis were impaired mobility (adjusted odds ratio [aOR], 2.35; 1.59-3.46), impaired functional status defined as Eastern Cooperative Oncology Group Performance Status ≥ 2 (aOR, 2.39; 1.66-3.43) or as activities of daily living < 6 (aOR, 2.43; 1.73-3.41), inpatient status (aOR, 1.68; 1.20-2.37), inadequate social support (aOR, 1.66; 1.16-2.37), cognitive impairment (aOR, 1.76; 1.24-2.49), polypharmacy defined as five or more non-antidepressant drugs (aOR, 1.65; 1.14-2.38), multimorbidity (aOR additional CIRS-G point , 1.08; 1.04-1.12), and cancer-related pain (aOR, 1.76; 1.26-2.46).
  
  
  CONCLUSIONS
  In older patients with as-yet untreated cancer at various sites and stages, clinical depression was highly prevalent. Clinical depression was independently associated with several geriatric assessment findings (impaired mobility and function, inadequate social support, cognitive impairment, polypharmacy, and multimorbidity) independently from gender, tumor site, and metastatic status.
authors.affiliation: APHP, Hôpital Henri-Mondor, Service de Santé Publique, F-94000, Créteil, France.|Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Canoui-Poitrine
authors.affiliation: Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.|APHP, Hôpital Henri-Mondor, Département de Gériatrie, Unité de Coordination en Onco-Gériatrie UCOG Sud Val-de-Marne, F-94000, Créteil, France.
authors.forename: Nicoleta
authors.initials: N
authors.lastname: Reinald
authors.affiliation: Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.|APHP, Hôpital Henri-Mondor, Département de Gériatrie, Unité de Coordination en Onco-Gériatrie UCOG Sud Val-de-Marne, F-94000, Créteil, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Laurent
authors.affiliation: APHP, Hôpital Henri-Mondor, Service de Santé Publique, F-94000, Créteil, France.|Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.|APHP, Hôpital Henri-Mondor, Unité de Recherche Clinique (URC-Mondor), F-94000, Créteil, France.
authors.forename: Esther
authors.initials: E
authors.lastname: Guery
authors.affiliation: Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.|APHP, Hôpital Henri-Mondor, Département de Gériatrie, Unité de Coordination en Onco-Gériatrie UCOG Sud Val-de-Marne, F-94000, Créteil, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Caillet
authors.affiliation: Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.|APHP, Hôpital Emile-Roux, Département de Gériatrie, F-94450, Limeil-Brévannes, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: David
authors.affiliation: APHP, Hôpital Henri-Mondor, Service d'Oncologie Médicale, F-94010, Créteil, France.|Université Paris Est, UPEC, DHU VIC, unité EC2M3, F-94000, Créteil, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tournigand
authors.affiliation: APHP, Hôpital Henri-Mondor, Service de Radiothérapie, F-94000, Créteil, France.|Université Paris Est, UPEC, Faculté de Médecine, F-94000, Créteil, France.
authors.forename: Jean-Leon
authors.initials: JL
authors.lastname: Lagrange
authors.affiliation: APHP, Hôpital Henri-Mondor, Service de Santé Publique, F-94000, Créteil, France.|Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.|APHP, Hôpital Henri-Mondor, Unité de Recherche Clinique (URC-Mondor), F-94000, Créteil, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Bastuji-Garin
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.|APHP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie de l'adulte et du sujet âgé, F-75015, Paris, France.|Inserm, U894, Centre Psychiatrie et Neurosciences, F-75015, Paris, France.
authors.forename: Cedric
authors.initials: C
authors.lastname: Lemogne
authors.affiliation: Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.|APHP, Hôpital Henri-Mondor, Département de Gériatrie, Unité de Coordination en Onco-Gériatrie UCOG Sud Val-de-Marne, F-94000, Créteil, France.
authors.forename: Elena
authors.initials: E
authors.lastname: Paillaud
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy; D019338:Polypharmacy; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012944:Social Support