Purpose

The study aimed to describe the long-term trajectories of anxiety and depression among older cancer survivors and examine sociodemographic and health-related predictors of different trajectories.

Methods

Data were from the National Health and Aging Trends Study. Patient Health Questionnaire-4 was used to assess anxiety and depression. Group-based trajectory model was used to identify the distinct trajectories of anxiety and depression from 2015 to 2021. Design-based multinomial logistic regression was used to examine predictors of different trajectories. All analyses accounted for the complex sample design and survey weights.

Results

A total of 1766 older cancer survivors were included representing 8.9 million older cancer survivors. The prevalence of anxiety and depression from 2015 to 2021 ranged from 25.12 to 29.11%. Four trajectories were identified: sustained low-risk (49.0%), deteriorating (24.1%), meliorating (11.0%), and sustained high-risk (16.1%). Potential predictors of high-risk anxiety and depression include older age, female, lower annual income, abnormal BMI, poorer self-rated health, more difficulty in activities of daily living (ADL), and worse cognitive function (P < 0.05).

Conclusions

The anxiety and depression progression patterns are heterogeneous among older cancer survivors. The trajectory affiliations could be predicted by sociodemographic and health-related factors, which have the potential to inform targeted clinical strategies (e.g., improve ADL and ameliorate cognitive function).

Implications for Cancer Survivors

Anxiety and depression are common among older cancer survivors, and long-term trajectories identified by this study might help realize early-stage identification and individualized interventions for mental disorders.

中文翻译：

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老年癌症幸存者焦虑和抑郁的轨迹和预测因素：一项全国代表性队列研究

目的

该研究旨在描述老年癌症幸存者焦虑和抑郁的长期轨迹，并检查不同轨迹的社会人口学和健康相关预测因素。

方法

数据来自国家健康和老龄化趋势研究。患者健康问卷 4 用于评估焦虑和抑郁。基于群体的轨迹模型用于识别 2015 年至 2021 年焦虑和抑郁的不同轨迹。基于设计的多项逻辑回归用于检查不同轨迹的预测因子。所有分析都考虑了复杂的样本设计和调查权重。

结果

总共包括 1766 名老年癌症幸存者，代表 890 万老年癌症幸存者。 2015年至2021年焦虑和抑郁的患病率为25.12%至29.11%。确定了四种轨迹：持续低风险（49.0%）、恶化（24.1%）、改善（11.0%）和持续高风险（16.1%）。高风险焦虑和抑郁的潜在预测因素包括年龄较大、女性、年收入较低、BMI异常、自评健康状况较差、日常生活活动（ADL）困难以及认知功能较差（P <  0.05）。

结论

老年癌症幸存者的焦虑和抑郁进展模式是异质的。轨迹隶属关系可以通过社会人口统计学和健康相关因素来预测，这些因素有可能为有针对性的临床策略提供信息（例如，提高 ADL 和改善认知功能）。

对癌症幸存者的影响

焦虑和抑郁在老年癌症幸存者中很常见，这项研究确定的长期轨迹可能有助于实现精神障碍的早期识别和个体化干预。