Background: Although older adults make up the largest percentage of cancer patients, comparatively few studies have focused on understanding the different effect of cancer on psychological and physical well being in the old afe as against to younger age, and the factors that may account for the differences.
Aims: To present an integrative review of three studies by our group on psychological and physical outcomes of cancer in old age as against younger age, and to present several possible explanatory factors.
Methods: Two studies were conducted with breast cancer patients, with 83 and 94 patients respectively; one study was with 92 colorectal patients. Participants in each study were split into two groups, aged younger and older than 65 years. Statistical analyses included structural equation modeling and tests of mediation.
Results: The first two studies showed lower distress and lower fatigue but higher levels of sleep problems in older breast cancer patients. The association between distress and fatigue was significantly stronger in the younger than in the older group. Results of the different patterns of association between distress, fatigue and pro-inflammatory cytokine in older and younger cancer patients will be presented too. In the study with colorectal cancer patients, lower levels of distress were found among the older patients. The relation between age and distress was mediated by personal resilience, which was significantly higher among the older cancer patients.
Conclusions: Older and younger cancer patients differ in levels of distress, fatigue and sleep problems, and in the relations among these factors. In addition to the contribution of tumor- and treatment-related factors, the studies show that psycho-social resources such as resilience also play a part in the diverse expression of symptoms.