Age-specific influences of emotional distress on performance status in cancer patients

Objective: Improving and maintaining performance status is an important part of cancer treatment because it may predict patients' survival. Several cancer-related medical conditions have been known to influence the functional performance of cancer patients. We here examined whether emotional distress would also contribute to performance decline of cancer patients.

Methods: With consecutive sampling, a total of 880 patients diagnosed as having cancer were recruited and evaluated on cancer-related variables, emotional distress, and performance status using the standardized instruments.

Results: Approximately 8.9% of participants showed compromised performance rated 2 or more on the Eastern Cooperative Oncology Group performance status scale. Emotional distress was strongly associated with compromised performance after controlling for demographic and cancer-related external risk factors. The effects of emotional distress on performance decline were likely to be remarkably greater in the younger age group (<45 years) than in old-aged cancer patients (≥65 years).

Conclusions: Our results provide support for the independent effects of emotional distress on having a higher risk for performance decline in cancer patients. These effects seem to be age-dependent suggesting that special clinical attention to emotional distress may be required in younger patients with cancer.