Depressive Symptoms and Poor Functional Status are Factors Associated with Frailty and Decreased Quality of Life in Thai Older Breast Cancer Survivors

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Objective: This study examines the prevalence and clinical factors associated with frailty, poor health-related quality of life (HR-QoL), and the combined presence of both in older breast cancer survivors. Materials and Methods: In this cross-sectional study, 230 BSC patients aged > 60 years and > 3 years cancer free were recruited. Frailty and HR-QoL were evaluated using the Fried Frailty Phenotype and the Functional Assessment of Cancer Therapy-Breast (FACT-B), respectively. As well, overall health status was assessed through a comprehensive geriatric assessment (CGA). Logistic regression was used to identify factors independently associated with frailty and reduced HR-QoL. Results: Of all 230 BCS, 16.5% were frail, 47.4% were pre-frail, and 36.1% were robust. Depressive symptoms were strongly associated with frailty (OR: 13.1, 95% CI: 4.04–42.74), indicating that individuals with these symptoms were 13 times more likely to be frail. Low physical activity (OR: 5.7, 95% CI: 2.1–15.08) and unmarried status (OR: 2.75, 95% CI: 1.47–19.57) were also significant predictors of frailty. Frail participants had notably lower HR-QoL scores than those who were non-frail. Conclusion: This study highlights the significant impact of depressive symptoms, reduced physical function, and social factors on frailty and HR-QoL in old-age BCS. Comprehensive geriatric assessment, including mental health and social support evaluations, are essential for early identification and intervention. Further research should focus on additional interventions aimed at reducing frailty and enhancing HR-QoL.

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