Functional and cognitive impairment , depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes .
OBJECTIVES Older head and neck cancer patients are at increased risk for adverse health outcomes , but little is known about which geriatric assessment associates with poor outcome .
The aim is to study the association of functional or cognitive impairment , social environment and frailty with adverse health outcomes in patients with head and neck cancer .
Depression as a predictor of postoperative functional performance status (PFPS) and treatment adherence in head and neck cancer patients: a prospective study
Background Head and neck cancer ( HNC ) is a debilitating disease due in part to its effects on function , including speech , swallowing , and cosmesis . Previous studies regarding depression in HNC have focused on demographic predictors , incidence , and quality of life studies . There is , however , a paucity of studies that objective ly address depressive symptoms in HNC patients and the result ant effects on post-treatment functional performance status . The aim of this study was to assess the relationship between preoperative depressive symptoms  ( PDS ) and postoperative functional performance status ( PFPS ) , in addition to other predictors of rehabilitation and survival . Methods A prospect i ve cohort study was undertaken at the University of Alberta , including all new adult HNC patients undergoing surgery as primary therapy for HNC from May 2013 to January 2014 . Baseline depressive symptoms  were measured on the Quick Inventory of Depressive Symptoms ( QIDS ) question naire 2 weeks preoperatively and PFPS was assessed 12 months postoperatively on the Functional Assessment of Cancer Therapy-Head & Neck ( FACT-HN ) scale . Secondary outcomes included completion of adjuvant therapy , narcotic dependence , return to detrimental habits , loss of follow-up , and length of hospital stay ( LOHS ) . Differences between the Normal-Mild and Moderate-Severe QIDS groups were assessed using Mann – Whitney and Fischer Exact statistical analyses . Results Seventy-one patients were included in the study . Mild and Moderate-Severe PDS were 35.2 % and 18.3 % , respectively . Significantly lower FACT-HN scores were noted in the Moderate-Severe group at 12 months ( p = 0.03 ) . The risk ratio ( RR ) for FACT-HN score < 50 % at 12 months in the Moderate-Severe group was 5.66 . In addition , significantly lower completion of adjuvant treatment ( p = 0.03 ) , significantly higher incidence of narcotic dependence ( p = 0.004 ) , and significantly higher LOHS ( 24 days vs. 18 days ; p = 0.02 ) was observed in the Moderate-Severe group . There was no significant difference in loss of follow-up between the 2 groups ( p = 0.64 ) . Conclusions The incidence and severity of PDS in HNC patients treated with surgery is high ( 53.5 % ) . Patients with Moderate-Severe PDS have significantly decreased PFPS , increased narcotic use , decreased completion of adjuvant therapy , and a longer LOHS . HNC patients should be monitored closely for depressive symptoms
Functional and cognitive impairment , depressive symptoms and social isolation are highly prevalent in head and neck cancer patients and associate with high risk of adverse health outcomes .
OBJECTIVES Older head and neck cancer patients are at increased risk for adverse health outcomes , but little is known about which geriatric assessment associates with poor outcome .
The aim is to study the association of functional or cognitive impairment , social environment and frailty with adverse health outcomes in patients with head and neck cancer .