Congress Abstracts 2005

22

SYMPTOM CORRELATES IN THE GERIATRIC ONCOLOGY POPULATION: AN EVIDENCE-BASED REVIEW. Cheryl Lacasse, RN, MS, OCN^®, The University of Arizona College of Nursing, Tucson, AZ, and Ann Reiner, RN, MN, OCN^®, Oregan Health and Science Center, Portland, OR.

Cancer-related symptoms have been studied for over 2 decades, yet little is known about the effect of age on the cancer symptom experience. Symptom management in the geriatric oncology population is a body of knowledge which is developing from a blending of existing knowledge in cancer symptom management and geriatric healthcare.

This review provides an overview of current knowledge in the area of cancer-related symptoms such as pain, fatigue, sleep disturbances, decreased physical functioning, and mood changes in the geriatric oncology population.

A comprehensive literature review of published research studies from 1993–2003 which included at least 33% of participants aged 55 years and older yielded 23 studies. Qualifying studies explored the relationships between various aspects of aging and select symptoms. Studies were analyzed for their contribution to the understanding of symptom distress and the inter-relationship of multiple variables within the geriatric population such co-morbidity, age, and functional loss. Analysis also focused on the impact of the symptom experience on daily living of the geriatric population including symptom severity and distress, physical functioning, and symptom clusters.

Critical analysis of the research indicates that older adults may perceive symptoms differently than younger patients and that this perception may be mediated by an increased number of co-morbidities and multiple symptom correlates. Evidence suggests: elders undergoing treatment frequently report pain and fatigue which are associated with a high number of other symptoms such as sleep disturbance, functional loss and depression; chronological age predicts symptom severity, but not symptom distress; increased symptom severity affects mental health and functional status. Age alone was found to be a weak predictor of functional loss.

Symptoms in older adults with cancer are framed within the normal aging experience. It is essential that oncology clinicians be aware of the nuances of symptom assessment in the elderly cancer patient including prevalence, intensity, severity, correlating symptoms and factors, and the interference with daily living the symptoms create. This presentation will review current evidence for assessing multiple symptoms in the elderly cancer population and implications for comprehensive geriatric oncology symptom management.