Geriatric impairments in cancer patients affect caregiver health, QOL

A higher number of geriatric assessment (GA) domain impairments in older patients with advanced cancer is significantly associated with caregiver depression, lower caregiver quality of life (QOL), and reduced caregiver physical heath, according to a study of 541 patients age 70 and older.

The study used baseline data from older patients with advanced cancer and their caregivers enrolled in the Improving Communication in Older Cancer Patients and Their Caregivers (COACH) study at 31 community oncology practices.

The mean number of GA domain impairments in the patients (average age 76.8 years) was 4.48, and 89.6% had three or more impairments.

Caregivers, the majority being female, (average age 66.5 years) completed the Generalized Anxiety Disorder-7, Distress Thermometer, Patient Health Questionnaire-2 (depression), and Short Form Health Survey-12 (SF-12 for QOL). Almost half (43.5%) of caregivers screened positive for distress, 24.4% for anxiety, and 18.9% for depression.

Importantly, two patient GA domain scores had strong independent associations that impacted caregivers.  Compromised patient nutrition status was associated with caregiver depression (p<0.01) and impaired functional status correlated with poorer caregiver physical health (p<0.05) and QOL (p<0.001).

An editorial published with the research article proposes a multidisciplinary care approach for both patients and their caregivers that incorporates interdisciplinary collaboration and interventions to identify areas where caregivers need extra assistance.

The researchers concluded that “the clinical team should address caregiver needs especially when the patient's GA shows a high number of domain impairments and/or when patients have significant nutritional, functional, or mental health concerns.”

Kehoe LA, et al., J Am Geriatr Soc