# Symptom Burden and Dietary Changes Among Older Adults with Cancer: A Cross-Sectional Study
## 3 Results
### Symptom Burden--An Underestimated Player
\begin{table}
\begin{tabular}{c c c c} \hline \hline
**Nutritional Status** & \
\begin{tabular}{c} **Symptom** \\ **Positive** \\ **[N]** \\ \end{tabular} &
\begin{tabular}{c} **Symptom** \\ **Negative** \\ **[N]** \\ \end{tabular} & \(p\)**-Value** \\ \hline \hline \multicolumn{4}{c}{**Dysgeusia**} \\ \hline
**NRS-2002 positive** & 76 & 133 & \\ \hline
**NRS-2002 negative** & 7 & 23 & 0.0997 \\ \hline \multicolumn{4}{c}{**Dysphagia**} \\ \hline
**NRS-2002 positive** & 50 & 159 & \\ \hline
**NRS-2002 negative** & 6 & 24 & 0.8183 \\ \hline \multicolumn{4}{c}{**Diarrhea**} \\ \hline
**NRS-2002 positive** & 34 & 175 & \\ \hline
**NRS-2002 negative** & 5 & 25 & 1.0000 \\ \hline
**Meteorism** & & \\ \hline
**NRS-2002 positive** & 51 & 157 & \\ \hline
**NRS-2002 negative** & 6 & 24 & 0.6554 \\ \hline
**NRS-2002 positive** & 47 & 162 & \\ \hline
**NRS-2002 negative** & 8 & 22 & 0.6441 \\ \hline \multicolumn{4}{c}{**Xerostomia**} \\ \hline
**NRS-2002 positive** & 138 & 71 & \\ \hline
**NRS-2002 negative** & 12 & 18 & **0.0082** \\ \hline
**NRS-2002 positive** & 104 & 105 & \\ \hline
**NRS-2002 negative** & 12 & 18 & 0.3362 \\ \hline
**Odynophagia** & & \\ \hline
**NRS-2002 positive** & 23 & 186 & \\ \hline
**NRS-2002 negative** & 3 & 27 & 1.0000 \\ \hline
**Constipation** & & \\ \hline
**NRS-2002 positive** & 64 & 144 & \\ \hline
**NRS-2002 negative** & 6 & 24 & 0.2863 \\ \hline
**Abdominal discomfort** & & \\ \hline
**NRS-2002 positive** & 31 & 178 & \\ \hline
**NRS-2002 negative** & 2 & 28 & 0.3929 \\ \hline
**Emesis** & & \\ \hline
**NRS-2002 positive** & 14 & 195 & \\ \hline
**NRS-2002 negative** & 2 & 28 & 1.0000 \\ \hline Nutritional Risk Score-2002—NRS-2002. & & & \\ \end{tabular}
\end{table} 
Table 4: \(Cont.\) \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Cancer Entity** & \
\begin{tabular}{c} **Symptom** \\ **Positive** \\ **[N]** \\ \end{tabular} &
\begin{tabular}{c} **Symptom** \\ **Negative** \\ **[N]** \\ \end{tabular} & \(p\)**-Value** \\ \hline \hline \multicolumn{4}{c}{**Mucositis**} \\ \hline
**Hematological neoplasm** & 32 & 155 & \\ \hline
**Solid tumor** & 16 & 97 & 0.5212 \\ \hline \multicolumn{4}{c}{**Dysgeusia**} \\ \hline
**Hematological neoplasm** & 65 & 122 & \\ \hline
**Solid tumor** & 28 & 85 & 0.0730 \\ \hline \hline \end{tabular}
\end{table} 
Table 5: Symptom burden comparing patients with either hematological neoplasms or solid tumors. Depicting symptom patterns by heat-map (Figure 3), we were able to observe certain symptom patterns that were more typical for patients with hematological neoplasms (e.g., loss of appetite, dysgeusia, nausea) or patients suffering from solid cancers (e.g., dysphagia, odynophagia, constipation). A significant correlation was found between radiotherapy and dysphagia (\(p<0.001\)) and odynophagia (\(p=0.017\)). We observed a trend toward less frequent dysgeusia in patients who were recently diagnosed compared to cancer patients under prolonged therapy (\(p=0.074\)). The symptom burden in relation to treatment modality is depicted in Table 6.  
In regard to symptom burden, there was a significant difference between the age cohorts (\(<\)75 years; \(\geq\)75 years). The cohort of patients over 75 years was significantly more likely to have xerostonia (\(p=0.015\)), dysphagia (\(p=0.110\)), and constipation (\(p=0.08\)). In contrast, dysgeusia (\(p=0.120\)) and diarrhea (\(p=0.003\)) were described more frequently in the cohort of younger patients (age \(<75\) years, also refer to Table 7).