In observing individuals aged 65 and older suffering from a recent nonmetastatic cancer, researchers indicated that there is a need to change attitudes toward aging and older people.
Findings published in Cancer Medicine suggested that self-perception of aging may influence the mortality of older people, particularly in the context of oncology.
In particular, older people with a negative self-perception of aging, measured up to 6 years earlier, are 3.66 times more likely to die than people with a positive self-perception of aging.
“Therefore, there is a need to change our attitude toward aging and older people: such changes need to be supported by policy and public health measures. For instance, it would be important to include more positive images of aging in public media or have more initiatives of intergenerational contact,” the study authors wrote. “By such action, we could hope that aging will be seen as a period of life not constituted on health issues and loneliness but on meaningful activities, personal growth, and pleasure.”
In this cohort of 140 participants aged 65 years and older suffering from a recent nonmetastatic cancer (breast, lung, gynecological, or hematological) were followed up to 6 years. Researchers used a Cox proportional hazards model to look at the effect of self-perception of aging at baseline on mortality. They then adjusted for age, gender, educational and cognitive level, oncological information (the site and kind of cancer), number of comorbidities, and physical and mental health at baseline.
The self-perception of aging score ranged from 45-114, and the median score was 87. Among the 45 patients who died during follow-up, 33 (73.33%) had a negative score. Researchers observed better survival in those who indicated a positive self-perception of aging. The median survival time of those with the negative scores was 1,330 days (range, 1,020 days to 1,640 days), whereas the estimated median survival was not reached for the positive self-perception of aging.
Cox regression suggested that patients with a negative score are 3.66 times more likely to die than subjects with a positive self-perception of aging (P < 0.001). After controlling for all covariates, results still indicated that a negative score increased the risk of death by 3.62. Researchers also observed significant effects of medical characteristics, like a diagnosis of lung cancer versus breast cancer and having 3 or more comorbidities (in comparison to none) were associated with an increased likelihood of death. Additionally, a higher mortality was observed among men and patients who report more physical difficulties at baseline.
“Our research support the view that (self-perception of aging) could be considered as a risk factor of vulnerability,” the authors wrote. “Therefore, it could constitute an interesting tool for oncologists in clinical practice, in order to assess the patient in a global way, improving predictions of possible evolution, provide an appropriate follow-up, and so improve quality care.”
Furthermore, researchers indicated that it is more necessary to sensitize health care professionals to the consequences of a negative SPA for older patients and to emphasize the importance of their attitudes.
A notable limitation of the study was that researchers did not have information regarding the cause of death in the study patients, therefore the mortality of the participants could have been due to cancer, or another disease or accident. Moreover, only information concerning self-perception of aging and other covariables were available at the time of diagnosis. Had they had information on self-perception of aging before diagnosis and been able to compare, they may have been able to provide a better understanding of the mechanism of it.
The authors suggested that future studies analyze the benefits of different procedures to change self-perception of aging among older patients in oncology; for example, by using self-affirmation techniques.
Schroyen S, Letenneur L, Missotten P, JÃ©rusalem G, Adam S. Impact of self-perception of aging on mortality of older patients in oncology. Cancer Medicine. doi:10.1002/cam4.2819.