The Experience of Depression in Older Adults With Cancer: A Qualitative Descriptive Analysis

Older adults with cancer (OACs) are a large and vulnerable population, with approximately 15% reporting clinically significant depressive symptoms. Yet, OACs are more likely than younger patients to decline a mental health referral. Understanding OACs' experience of depression and view of mental health resources is vital to inform improvements to care for this population.

To describe OACs' perspectives on (1) depression during cancer and (2) strategies for coping with depression, including mental health services using a qualitative descriptive study approach.

OACs (≥ 65 years old) with depressive symptoms were recruited to participate in focus groups, which were informed by a semi-structured facilitation guide. Qualitative data were analyzed using reflexive thematic analysis. Descriptive statistics were used to analyze participant characteristics (e.g., demographics, cancer history).

OACs (n = 13, M_age = 75.0) participated. Five key themes emerged: (1) Depressive symptoms as inherently tied to the cancer experience; (2) Distress symptoms disrupt daily life; (3) Cancer-related depressive symptoms as unique and not warranting support; (4) Preference for personal coping strategies to manage depressive symptoms; and (5) Logistical and access barriers impact mental health care initiation and engagement.

Study findings highlight OACs' unique perspectives on depression and suggest that these views and their preference for personal coping strategies may further hinder mental health service engagement.