OBJECTIVE: To explore the relationships between age, reported symptoms and dependency in the last year of life in those dying from cancer and in those dying from other causes. DESIGN: Secondary analysis of data from the Regional Study of Care for the Dying, a retrospective interview survey of deaths in 1990 in 20 nationally representative English health districts. There were 2061 cancer deaths and 1469 non-cancer deaths (sudden deaths were excluded). MAIN RESULTS: In cancer patients, the mean number of symptoms reported to have been experienced in the last year of life decreased with age (from 8.29 in those aged <65 to 7.79 in those aged 65 -74, 7.37 in those aged 75-84 and 7.42 in those aged 85 and older), while the number of symptoms reported to have lasted more than 6 months increased (2.93, 3.15, 3.24 and 3.52). In both cancer and non-cancer patients the proportion of symptoms reported to have been 'very distressing' decreased with age (cancer, 45, 43, 40 and 35%; non-cancer, 39, 38, 34 and 27%). In non-cancer patients the mean number of self-care tasks the deceased had needed help with increased substantially with age (2.23, 2.50, 3.04 and 3.95); in cancer patients the mean level was higher and there was no age gradient (3.89, 3.94, 3.83 and 4.1). The prevalence of dependency on most of the seven self-care tasks in cancer patients was comparable with or higher than that in the older and most restricted non-cancer patients. CONCLUSION: Younger cancer patients are more likely than older cancer patients to need help with relieving distressing symptoms. However, some elderly patients were reported to have had very distressing symptoms, and these patients should not be excluded from specialist palliative care services on the basis of their age. Cancer patients did not show increased dependency with age, indicating the importance of community health and social services being appropriate for and accessible by cancer patients of all ages.
OBJECTIVE: To explore the relationships between age, reported symptoms and dependency in the last year of life in those dying from cancer and in those dying from other causes. DESIGN: Secondary analysis of data from the Regional Study of Care for the Dying, a retrospective interview survey of deaths in 1990 in 20 nationally representative English health districts. There were 2061 cancer deaths and 1469 non-cancer deaths (sudden deaths were excluded). MAIN RESULTS: In cancerpatients, the mean number of symptoms reported to have been experienced in the last year of life decreased with age (from 8.29 in those aged <65 to 7.79 in those aged 65 -74, 7.37 in those aged 75-84 and 7.42 in those aged 85 and older), while the number of symptoms reported to have lasted more than 6 months increased (2.93, 3.15, 3.24 and 3.52). In both cancer and non-cancerpatients the proportion of symptoms reported to have been 'very distressing' decreased with age (cancer, 45, 43, 40 and 35%; non-cancer, 39, 38, 34 and 27%). In non-cancerpatients the mean number of self-care tasks the deceased had needed help with increased substantially with age (2.23, 2.50, 3.04 and 3.95); in cancerpatients the mean level was higher and there was no age gradient (3.89, 3.94, 3.83 and 4.1). The prevalence of dependency on most of the seven self-care tasks in cancerpatients was comparable with or higher than that in the older and most restricted non-cancerpatients. CONCLUSION: Younger cancerpatients are more likely than older cancerpatients to need help with relieving distressing symptoms. However, some elderly patients were reported to have had very distressing symptoms, and these patients should not be excluded from specialist palliative care services on the basis of their age. Cancerpatients did not show increased dependency with age, indicating the importance of community health and social services being appropriate for and accessible by cancerpatients of all ages.
Authors: Aaron M Olden; Robert Holloway; Susan Ladwig; Timothy E Quill; Edwin van Wijngaarden Journal: J Pain Symptom Manage Date: 2011-03-27 Impact factor: 3.612
Authors: Louise Jones; Bridget Candy; Sarah Davis; Margaret Elliott; Anna Gola; Jane Harrington; Nuriye Kupeli; Kathryn Lord; Kirsten Moore; Sharon Scott; Victoria Vickerstaff; Rumana Z Omar; Michael King; Gerard Leavey; Irwin Nazareth; Elizabeth L Sampson Journal: Palliat Med Date: 2015-09-09 Impact factor: 4.762