title: The Value of Fatigue Severity to Rule Out Depression in Older Adult Patients With Cancer.
abstract: OBJECTIVE
  To evaluate whether fatigue severity can serve as a cue to investigate the presence of depression in older adult patients with cancer.
  
  
  METHODS
  Cross-sectional observational cohort study.
  
  
  METHODS
  Seven hospitals and general practices in Belgium and the Netherlands.
  
  
  METHODS
  205 older adult patients with cancer and 436 older adults without cancer (aged 70 years or older).
  
  
  METHODS
  The diagnostic accuracy of fatigue as a proxy for depression was evaluated using sensitivity, specificity, and predictive values.
  
  
  METHODS
  Fatigue was measured with a visual analog scale, and depression was measured with the 15-item Geriatric Depression Scale.
  
  
  RESULTS
  Fifty-six percent of the population experienced fatigue, and 13% were depressed. For fatigue as a cue for depression, sensitivity was 82%, specificity was 47%, positive predictive value was 18%, and negative predictive value was 95%.
  
  
  CONCLUSIONS
  The data confirm that fatigue is a valuable cue to investigate the presence of depression because 82% of depressed participants were correctly identified by fatigue. The assessment of fatigue severity is intuitive, quick, straightforward, and usually already implemented.
  
  
  CONCLUSIONS
  Identification of depression is difficult in older adult patients with cancer. Instead of experiencing affective symptoms of depression, older adult patients are more likely to disclose somatic symptoms, such as fatigue, which often overlap with cancer-related symptoms. Nurses should be aware of this problem and should be alert for the possibility of depression in older adult patients presenting with fatigue.
authors.affiliation: KU Leuven in Belgium and the University of Queensland in Australia.
authors.forename: Laura
authors.initials: L
authors.lastname: Deckx
authors.affiliation: KU Leuven in Belgium and Maastricht University in the Netherlands.
authors.forename: Marjan
authors.initials: M
authors.lastname: van den Akker
authors.affiliation: VU University Medical Center in Amsterdam.
authors.forename: Denise
authors.initials: D
authors.lastname: Vergeer
authors.affiliation: Maastricht University Medical Centre in the Netherlands.
authors.forename: Doris
authors.initials: D
authors.lastname: van Abbema
authors.affiliation: Atrium Medical Centre Parkstad in Heerlen, the Netherlands.
authors.forename: Franchette
authors.initials: F
authors.lastname: van den Berkmortel
authors.affiliation: University Biobank Limburg and Jessa Hospital in Hasselt, Belgium.
authors.forename: Loes
authors.initials: L
authors.lastname: Linsen
authors.affiliation: Ziekenhuis Oost-Limburg in Genk, Belgium.
authors.forename: Eric T
authors.initials: ET
authors.lastname: de Jonge
authors.affiliation: Jessa Hospital in Hasselt, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Houben
authors.affiliation: University of Queensland in Brisbane, Australia.
authors.forename: Mieke
authors.initials: M
authors.lastname: van Driel
authors.affiliation: KU Leuven in Belgium and Maastricht University in the Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Buntinx
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001530:Belgium; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000209:etiology / Q000451:nursing; D005221:Fatigue / Q000175:diagnosis* / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications*; D009426:Netherlands; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: aging; cancer in older adults; depression; fatigue; screening