BACKGROUND: Studies are lacking on how anxiety and depression symptoms influence mortality among cognitively intact older people in nursing homes (NHs) with a diagnosis of cancer versus those without cancer. OBJECTIVE: We hypothesized that anxiety or depression was associated with survival and has greater effects on survival for residents with cancer than for those without cancer. METHODS: A cohort of 227 cognitively intact (Clinical Dementia Rating scale score ≤0.5) older residents (60 with cancer and 167 without) from 30 NHs were followed from 2004-2005 to 2010. Data were collected using face-to-face interviews. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale subscales. Sociodemographic variables and medical diagnoses were obtained from the records. RESULTS: The overall survival after 5 years was 17% for residents with cancer and 22% for residents without cancer. Depression and comorbidity were associated with significantly worse survival independent of a cancer diagnosis. Residents with cancer and symptoms of anxiety (subscores at least 8) had worse survival than those without anxiety symptoms (P = .02), but this was not found among the noncancer group. CONCLUSIONS: Independent of a cancer diagnosis, depression symptoms and comorbidity were associated with mortality among cognitive intact NH residents. Having symptoms of anxiety predicted shorter survival among residents with a cancer diagnosis. IMPLICATIONS FOR PRACTICE: Nurses should pay attention to depression symptoms among NH residents with and without a cancer diagnosis. Giving attention to residents with cancer and anxiety symptoms is especially important.
BACKGROUND: Studies are lacking on how anxiety and depression symptoms influence mortality among cognitively intact older people in nursing homes (NHs) with a diagnosis of cancer versus those without cancer. OBJECTIVE: We hypothesized that anxiety or depression was associated with survival and has greater effects on survival for residents with cancer than for those without cancer. METHODS: A cohort of 227 cognitively intact (Clinical Dementia Rating scale score ≤0.5) older residents (60 with cancer and 167 without) from 30 NHs were followed from 2004-2005 to 2010. Data were collected using face-to-face interviews. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale subscales. Sociodemographic variables and medical diagnoses were obtained from the records. RESULTS: The overall survival after 5 years was 17% for residents with cancer and 22% for residents without cancer. Depression and comorbidity were associated with significantly worse survival independent of a cancer diagnosis. Residents with cancer and symptoms of anxiety (subscores at least 8) had worse survival than those without anxiety symptoms (P = .02), but this was not found among the noncancer group. CONCLUSIONS: Independent of a cancer diagnosis, depression symptoms and comorbidity were associated with mortality among cognitive intact NH residents. Having symptoms of anxiety predicted shorter survival among residents with a cancer diagnosis. IMPLICATIONS FOR PRACTICE: Nurses should pay attention to depression symptoms among NH residents with and without a cancer diagnosis. Giving attention to residents with cancer and anxiety symptoms is especially important.