Differences in the symptom experience of older versus younger oncology outpatients : a cross-sectional study

Cataldo, Janine K., Paul, Steven, Cooper, Bruce, Skerman, Helen M., Alexander, Kimberly, Aouizerat, Bradley, Blackman, Virginia, Merriman, John, Dunn, Laura, Ritchie, Christine, Yates, Patsy, & Miaskowski, Christine (2013) Differences in the symptom experience of older versus younger oncology outpatients : a cross-sectional study. BMC Cancer, 13(6), pp. 1-16.

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Background: Mortality rates for cancer are decreasing in patients under 60 and increasing in those over 60 years of age. The reasons for these differences in mortality rates remain poorly understood. One explanation may be that older patients received substandard treatment because of concerns about adverse effects. Given the paucity of research on the multiple dimensions of the symptom experience in older oncology patients, the purpose of this study was to evaluate for differences in ratings of symptom occurrence, severity, frequency, and distress between younger (< 60 years) and older ( ≥ 60 years) adults undergoing cancer treatment. We hypothesized that older patients would have significantly lower ratings on four symptom dimensions.

Methods: Data from two studies in the United States and one study in Australia were combined to conduct this analysis. All three studies used the MSAS to evaluate the occurrence, severity, frequency, and distress of 32 symptoms.

Results: Data from 593 oncology outpatients receiving active treatment for their cancer (i.e., 44.4% were < 60 years and 55.6% were ≥ 60 years of age) were evaluated. Of the 32 MSAS symptoms, after controlling for significant covariates, older patients reported significantly lower occurrence rates for 15 (46.9%) symptoms, lower severity ratings for 6 (18.9%) symptoms, lower frequency ratings for 4 (12.5%) symptoms, and lower distress ratings for 14 (43.8%) symptoms.

Conclusions: This study is the first to evaluate for differences in multiple dimensions of symptom experience in older oncology patients. For almost 50% of the MSAS symptoms, older patients reported significantly lower occurrence rates. While fewer age-related differences were found in ratings of symptom severity, frequency, and distress, a similar pattern was found across all three dimensions. Future research needs to focus on a detailed evaluation of patient and clinical characteristics (i.e., type and dose of treatment) that explain the differences in symptom experience identified in this study.

Impact and interest:

20 citations in Scopus
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16 citations in Web of Science®

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ID Code: 61685
Item Type: Journal Article
Refereed: Yes
Keywords: Geriatric oncology; Symptoms
DOI: 10.1186/1471-2407-13-6
ISSN: 1471-2407
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Deposited On: 06 Aug 2013 00:59
Last Modified: 18 Sep 2013 03:26

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