Abstract

Objective

The Geriatric Depression Scale (GDS-15), a self-report questionnaire, emphasizes the psychological dimension of depression. We aimed to investigate whether GDS-15 scores were associated with mortality in older patients with cancer and describe the course of individual symptoms on the GDS-15.

Methods

An observational, multicenter, prospective study of 288 patients 70 years or older with cancer followed over 24 months. The patients were assessed with the GDS-15 at inclusion, and after four and 12 months. An extended Cox regression model assessed the association between time-dependent GDS-15 scores and mortality.

Results

After adjusting for cancer-related prognostic factors, a one-point increase in GDS-15 sum score increased risk of death by 12%. GDS-15 mean score increased during the first four months of the study, as did odds for the presence of the GDS-15 symptoms ‘feel you have more problems with memory than most’, ‘not feel full of energy’, and ‘think that most people are better off than you’. The most prevalent and persistent GDS-15 symptom was ‘prefer to stay at home, rather than going out and doing new things’, and ‘not to be in good spirits most of the time’ was the least prevalent.

Conclusions

More severe depressive symptoms, as measured by the GDS-15, were associated with higher mortality in older patients with cancer. The importance of emotional distress and how to alleviate it should be investigated further in these patients.

中文翻译：

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老年癌症患者抑郁症状和死亡率的过程

摘要

客观的

老年抑郁量表（GDS-15）是一种自我报告问卷，强调抑郁症的心理维度。我们旨在调查 GDS-15 评分是否与老年癌症患者的死亡率相关，并描述 GDS-15 上个体症状的过程。

方法

一项对 288 名 70 岁或以上的癌症患者进行了为期 24 个月的观察性、多中心、前瞻性研究。患者在纳入时以及 4 个月和 12 个月后使用 GDS-15 进行评估。扩展的 Cox 回归模型评估了时间依赖性 GDS-15 评分与死亡率之间的关联。

结果

在调整癌症相关的预后因素后，GDS-15 总分增加 1 分会使死亡风险增加 12%。GDS-15 平均得分在研究的前四个月有所增加，出现 GDS-15 症状的几率也增加了“感觉你比大多数人有更多的记忆问题”、“感觉没有精力充沛”和“思考”大多数人都比你过得好”。最普遍和持续的 GDS-15 症状是“宁愿呆在家里，而不是出去做新事物”，而“大部分时间精神不振”是最不普遍的。

结论

根据 GDS-15 测量，更严重的抑郁症状与老年癌症患者的死亡率更高有关。应在这些患者中进一步研究情绪困扰的重要性以及如何减轻情绪困扰。