Background

Colorectal cancer (CRC) preferentially affects older adults. Modifiable factors, such as anxiety, can be measured as part of cancer-specific geriatric assessments (GA) completed prior to the start of treatment. We hypothesized that anxiety is prevalent among older adults with CRC and is associated with increased depression, increased frailty, and impaired health-related quality of life (HRQOL).

Patients and Methods

Patients ≥60 years old with newly diagnosed CRC completed a cancer-specific GA called the Cancer and Aging Resilience Evaluation (CARE). Between September 2017 and February 2023, we analyzed patients with CRC who had not yet received any systemic treatment. Anxiety was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety 4-item short form and reported as t-scores. We used modified Poisson models with robust variance estimation to assess for differences in the prevalence of depression, frailty, and impaired HRQOL.

Results

We analyzed 277 older adults with CRC. The median age of the study sample was 68 years. 57% were male, 72% were non-Hispanic White, and most had advanced CRC (35% stage III and 39% stage IV). Moderate/severe anxiety was present in 17% of older adults with newly diagnosed CRC. In adjusted models, as compared to patients without moderate/severe anxiety, patients with moderate/severe anxiety had significantly increased risk of depression (prevalence ratio [PR] 7.60, CI 4.90-11.78), frailty (PR 4.93, CI 3.01-8.07), impaired physical HRQOL (PR 3.57, CI 2.03-6.28), and impaired mental HRQOL (PR 3.82, CI 2.12-6.89).

Conclusion

Among older adults with CRC, anxiety is associated with increased depression and frailty as well as reduced HRQOL.

中文翻译：

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焦虑与老年结直肠癌患者的老年评估障碍和生活质量下降有关：来自 CARE 登记处的结果

背景

结直肠癌（CRC）优先影响老年人。可改变的因素，例如焦虑，可以作为治疗开始前完成的癌症特异性老年评估 (GA) 的一部分进行测量。我们假设焦虑在患有结直肠癌的老年人中普遍存在，并且与抑郁增加、虚弱程度增加以及健康相关生活质量 (HRQOL) 受损有关。

患者和方法

≥60 岁的新诊断 CRC 患者完成了癌症特异性 GA，称为癌症与衰老恢复力评估 (CARE)。2017年9月至2023年2月期间，我们分析了尚未接受任何全身治疗的CRC患者。使用患者报告结果测量信息系统 (PROMIS) 焦虑 4 项简表评估焦虑，并报告为 t 分数。我们使用具有稳健方差估计的修正泊松模型来评估抑郁、虚弱和 HRQOL 受损的患病率差异。

结果

我们分析了 277 名患有 CRC 的老年人。研究样本的中位年龄为 68 岁。57% 为男性，72% 为非西班牙裔白人，大多数患有晚期结直肠癌（35% 为 III 期，39% 为 IV 期）。17% 的新诊断 CRC 老年人存在中度/重度焦虑。在调整后的模型中，与没有中度/重度焦虑的患者相比，中度/重度焦虑的患者患抑郁症（患病率[PR] 7.60，CI 4.90-11.78）、虚弱（PR 4.93，CI 3.01-8.07）的风险显着增加，身体 HRQOL 受损（PR 3.57，CI 2.03-6.28），以及精神 HRQOL 受损（PR 3.82，CI 2.12-6.89）。

结论

在患有结直肠癌的老年人中，焦虑与抑郁和虚弱的增加以及 HRQOL 的降低有关。