SYSTEMATIC REVIEW
The Difficult Task of Diagnosing Depression in Elderly People with Cancer: A Systematic Review
Elena Massa1, *, Clelia Donisi1, Nicole Liscia1, Clelia Madeddu1, Valentino Impera1, Stefano Mariani1, Mario Scartozzi1, Eleonora Lai1
Article Information
Identifiers and Pagination:
Year: 2021Volume: 17
Issue: Suppl-1, M7
First Page: 295
Last Page: 306
Publisher ID: CPEMH-17-295
DOI: 10.2174/1745017902117010295
Article History:
Received Date: 18/2/2021Revision Received Date: 08/9/2021
Acceptance Date: 17/11/2021
Electronic publication date: 31/12/2021
Collection year: 2021
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Depression is a common psychiatric problem in the elderly and oncology patients. In elderly people with cancer, depression has a peculiar phenomenology. It has a significant impact on the quality of life. Moreover, it is associated with poor adherence to treatments, increased risk of suicide, and mortality. Nevertheless, the topic of depression in elderly people with cancer remains unexplored.
Objective:
The main goal of this article is to review the literature from the past 20 years on the relationships between depression, cancer, and aging.
Methods:
The methods followed the Prisma model for eligibility of studies. The articles in which the keywords “depression”, “cancer”, “ elderly, aging, or geriatric” were present, either in the text or in the abstract, were selected. 8.056 articles, by matching the keywords “depression and elderly and cancer,” were identified. Only 532 papers met the eligibility criteria of search limits and selection process. Out of 532 papers, 467 were considered irrelevant, leaving 65 relevant studies. Out of 65 suitable studies, 39 (60.0%) met our quality criteria and were included.
Results:
The risk factors associated with depression in elderly people with cancer can be divided into 4 groups: 1) tumor-related; 2) anticancer treatment-related; 3) patients-related; 4) number and type of comorbidity. The main obstacles in diagnosing depression in elderly patients with cancer are the overlap of the symptoms of cancer and side effects of treatment with the symptoms of depression but also the different ways of reporting depressive symptoms of elderly people and the different clinical types of depression. There is a lack of data regarding validated scales to assess depression in geriatric patients with cancer. Any mental illness, specifically co-occurring anxiety and depression, increases the risk of diagnosis delay and anticancer treatment adherence. Cancer and the diagnosis of mental disorders prior to cancer diagnosis correlate with an increased risk for suicide. A non-pharmacological therapeutic approach, pharmacological treatment and/or a combination of both can be used to treat elderly patients with cancer, but a detailed analysis of comorbidities and the assessment of polypharmacy is mandatory in order to avoid potential side-effects and interactions between antidepressants and the other drugs taken by the patients.
Conclusion:
Future research should be conducted with the aim of developing a modified and adapted assessment method for the diagnosis and treatment of depression in elderly people with cancer in order to improve their clinical outcomes and quality of life.
