Post-traumatic stress disorder symptoms and quality of life among older patients with cancer during the COVID-19 pandemic.

Abstract

INTRODUCTION:

The Coronavirus (COVID-19) pandemic and its associated health restrictions have harmed the population psychologically. We aimed to compare the post-traumatic stress disorder (PTSD) symptoms and Quality of Life (QoL) in older French patients with cancer to the younger ones.

MATERIALS AND METHODS:

This longitudinal multicenter study named COVIPACT began in April 2020 during the first French lockdown and has included 579 outpatients receiving treatment for a solid or hematological malignancy. Data were collected every three months, namely at the first release period (M3), at the second lockdown (M6), at the second release period (M9), and finally at the last curfew period (M12) in France. Standardized validated self-questionnaires were used to assess PTSD symptoms (using the Event Scale-Revised self-questionnaire), insomnia (through the Insomnia Severity Index questionnaire), QoL (using the Functional Assessment of Cancer Therapy - General questionnaire), and cognitive complaints (through the Functional Assessment of Cancer Therapy - Cognition questionnaire). Student (or Wilcoxon) tests and Chi-squared tests were used for continuous or discrete variables, respectively. We conducted linear mixed model to study the change during follow-up.

RESULTS:

Out of 579 included patients, 157 (27%) were ≥ 70 years old at baseline, of whom 104 participated in the longitudinal study. At baseline, older patients reported fewer PTSD symptoms (17% versus 23%, p = .06), insomnia (17% versus 27%, p = .02), and cognitive complaint (3% versus 16%, p < .01) than younger patients. QoL at baseline was similar between age subgroups. We observed no significant difference in the trajectory of PTSD symptoms, insomnia, or emotional well-being between both groups during the follow-up. Cognitive complaints were lower at baseline in older patients but steadily increased during the follow-up and reached the same level as younger patients at one year.

DISCUSSION:

One in five older patients reported PTSD symptoms, evolving similarly to younger patients during the first year of the COVID-19 pandemic. While cognitive complaints tend to recover in a bell-shaped curve at one year in younger patients, the trend is increasing in older ones. Screening for PTSD symptoms and late cognitive impairment should be given special attention in older patients.

TRIAL REGISTRATION:

Clinicaltrials.gov identifier: NCT04366154.

• Authors: Francois Cherifi, François Gernier, Fabrice Jardin, Sophie Lefevre-Arbogast, Etienne Bastien, Justine Lequesne, Olivier Rigal, Florian Quilan, Bénédicte Clarisse, Jean-Michel Grellard, Giulia Binarelli, Marie Fernette, Marie Lange, Doriane Richard, Adeline Morel, Bénédicte Griffon, Louis-Ferdinand Pepin, Alexandra Leconte, Audrey Faveyrial, Marianne Leheurteur, Bérengère Beauplet, Florence Joly
• Journal: Journal of geriatric oncology (J Geriatr Oncol) Vol. 14 Issue 8 Pg. 101634 (11 2023) ISSN: 1879-4076 [Electronic] Netherlands
• PMID: 37757587 (Publication Type: Multicenter Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2023. Published by Elsevier Ltd.

Topics

• Humans
• Aged
• Stress Disorders, Post-Traumatic (epidemiology, diagnosis, psychology)
• Quality of Life (psychology)
• Pandemics
• COVID-19 (epidemiology)
• Sleep Initiation and Maintenance Disorders (epidemiology)
• Longitudinal Studies
• Communicable Disease Control
• Neoplasms (therapy)