Polypharmacy, limited activity, fatigue and insomnia are the most frequent symptoms and impairments in older hematological cancer survivors (70+): Findings from a register-based study on physical and mental health.

OBJECTIVES: Although the median age at cancer diagnosis is about 70 years, few studies have evaluated physical and mental health in older patients. The main objectives of our study are to provide information about depression, functional disabilities and symptom burden in older hematological cancer patients (HCP), compared to a community sample (CS) of older individuals.

MATERIALS AND METHODS: We conducted a prospective study with interview assessments at a meantime of 26 month (range 1-60) after diagnosis or relapse of hematologic cancer (ICD: C81 - C96). Participants were 70 years or older. We assessed depressive symptoms (GDS-15), comorbid conditions, and physical symptom burden (EORTC QLQ-C30, Geriatric Screening) in comparison to a community sample matched by age and sex.

RESULTS: 200 patients (response rate 50.5%, Mean age = 76 years, 64% male) and 225 citizens (response rate 44.5%) were interviewed. HCP were more depressed than CS (GDS-15 Mean-score = 3.0 vs. 2.3; p = 0.006). Both HCP and CS had an average of 5 comorbid conditions. In comparison to CS, HCP were found to have higher levels of polypharmacy and limited activity, higher prevalence in polyneuropathy, and higher symptom burden of fatigue, insomnia, and appetite loss. The comorbidity-index was particularly high in older patients, in patients with low education level as well as in patients with a high depression-score.

CONCLUSIONS: Older HCP are at increased risk for depression and a variety of physical impairments compared to control population. Specific knowledge about disabilities and symptom burden could help to develop adequate survivorship-programs in this group of patients.