# The unseen struggle—depression and associated factors in geriatric cancer patients

## TL;DR

This study finds that over 40% of elderly cancer patients undergoing chemotherapy show high depression symptoms, linked to factors like pain, insomnia, and weak social support.

## Contribution

The study identifies specific, independent predictors of depression in geriatric cancer patients using the Geriatric Depression Scale.

## Key findings

- 42.7% of geriatric cancer patients undergoing chemotherapy showed high depressive symptoms.
- Female gender, higher BMI, pain, insomnia, and weak social support were significant predictors of depression.
- Early depression management could improve quality of life and treatment adherence in this population.

## Abstract

The objective of this study was to investigate the frequency of depression and its associations, rather than causal relationships, in patients aged 65 years and older receiving chemotherapy, using the Geriatric Depression Scale (GDS).

This prospective study was conducted between January 2023 and December 2023 at Ankara Etlik City Hospital, including 501 chemotherapy patients aged 65 years and older. Patients receiving only oral therapy, those under palliative care, those with brain metastases, or those with insufficient cognitive functionality were excluded. Demographic and clinical data were collected from medical records. Depression was assessed using the 15-item Yesavage Geriatric Depression Scale (GDS), with scores ≥5 indicating high depression symptoms.

Among the 501 patients included in the study, 204 (40.7%) were female, with a median age of 69 years (range: 65–84 years). A total of 214 patients (42.7%) had high depressive symptom scores (GDS ≥ 5). A multivariable logistic regression analysis identified the following as independent predictors of depression: being female (odds ratio (OR): 1.481, 95% confidence interval (CI): 1.011–2.168, p = 0.04), body mass index (BMI) ≥ 21 (OR: 1.665, 95% CI: 1.081–2.564, p = 0.02), higher pain scores (OR: 1.269, 95% CI: 1.122–1.436, p < 0.001), insomnia (OR: 1.626, 95% CI: 1.109–2.384, p = 0.01), and weak social support (OR: 2.004, 95% CI: 1.046–3.839, p = 0.03).

Our study highlights the high prevalence of depressive symptoms among geriatric cancer patients. In this population, early diagnosis and management of depression, with particular attention to independent risk factors such as pain and insomnia, as well as strengthening social support mechanisms, may be crucial for enhancing quality of life and improving treatment adherence.