Journal Article

Depressive symptoms, mental health-related quality of life, and survival among older patients with multiple myeloma

Sweiss, Karen, Chiu, Brian C.-H., Alobaidi, Ali, Ko, Naomi Y., Nabulsi, Nadia A., Asfaw, Alemseged A., Sharp, Lisa K., Calip, Gregory S., Patel, Pritesh R., Talon, Brian, Zhou, Jifang

2020

Overview

Purpose To examine the impact of pre-diagnosis depressive symptoms and mental health-related quality of life (HRQOL) on survival among older patients with multiple myeloma (MM). Methods We performed a retrospective cohort study using the Surveillance, Epidemiology, and End Results-Medicare Health Outcomes Survey data resource. Patients aged 65 years and older diagnosed with first primary MM between 1998 and 2014 were identified, and presence of depressive symptoms was determined based on responses to 3 depression screening questions prior to MM diagnosis. Veterans RAND 12 mental component summary (MCS) scores were analyzed to evaluate mental HRQOL. We used multivariable Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for risks of all-cause and cancer-specific mortality. Results Of 522 patients, mean (SD) age at diagnosis was 76.9 (6.1) years and 158 (30%) reported depressive symptoms. Patients with depressive symptoms had a higher number of comorbid conditions and nearly all (84%) scored below the median MCS. Pre-diagnosis depressive symptoms were not associated with all-cause (HR = 1.01, 95% CI 0.79–1.29) or cancer-specific mortality (HR = 0.94, 95% CI 0.69–1.28). MM patients scoring in the second MCS tertile (vs the highest tertile) had a modestly increased risk of all-cause (HR = 1.19, 95% CI 0.91–1.55) and cancer-specific mortality (HR = 1.17, 95% CI 0.86–1.60), but these estimates were not statistically significant. Conclusion Pre-diagnosis depressive symptoms and lower mental HRQoL did not impact survival among older MM patients. Highly prevalent depressive symptoms among older MM patients deserve clinical attention. Such efforts can inform clinicians in tailoring care for this vulnerable population.

• Publisher: Springer Berlin Heidelberg,Springer,Springer Nature B.V
• Subject: Aged / Aged patients / Aged, 80 and over / Analysis / Cancer / Clinical outcomes / Cohort analysis / Cohort Studies / Comorbidity / Depression - psychology / Depression, Mental / Epidemiology / Female / Health risk assessment / Health status / Humans / Male / Medical diagnosis / Medical screening / Medicare / Medicine / Medicine & Public Health / Mental depression / Mental health / Mental Health - trends / Mental health services / Mortality / Multiple myeloma / Multiple Myeloma - mortality / Multiple Myeloma - psychology / Myeloma / Nursing / Nursing Research / Older people / Oncology / Original Article / Pain Medicine / Palliative care / Patient outcomes / Patients / Prospective Studies / Quality of life / Quality of Life - psychology / Rehabilitation Medicine / Retrospective Studies / Scores / SEER Program / Surveillance / Surveys / Symptoms / Treatment Outcome / Veterans / Vulnerability