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Health Problems of Aging


HealthProblems of Aging

AnOutline of the evaluation of Three Journal Articles on Older Adultswith Cancer and Depression

  1. Current Problem: Most of the adults experience health challenges such as cancer and depression as they get older. Knowledge of the common health conditions among the elderly is very important because it equips them with the appropriate strategies and resources to curb these challenges as they age

  2. Area of focus/Population: Older cancer patients

  3. Key Terms: Depression, Locus of control, Coping strategies, Cognitive interventions

Thesis Statement: Comparison between three scholarly journalarticles that present different studies of proving the associationbetween locus of control, depression, coping strategies, andcognitive functioning in older adults suffering from different typesof cancer.

  1. Body

  1. Evaluation methods utilized in each study

  2. Results and Overall conclusions of each study

  1. Conclusion:

Anevaluation of three journal articles on older adults with cancer anddepression

Most of the adults experience health challenges as they get old.Knowledge of the common health conditions among the elderly iscritical because it equips them with the appropriate strategies andresources to curb these challenges as they age. However, for variousreasons, scholars hold differing views on depression and locus ofcontrol in cancer older patients. The following is a comparisonbetween three scholarly journal articles that present differentstudies of proving the association between locus of control,depression, coping strategies, and cognitive functioning in olderadults suffering from different types of cancer.

In the psycho-Oncology journal article “The relation betweendepression, coping, and health locus of control: differences betweenolder and younger patients, with and without cancer&quot, thefindings of Aarts, Deckx, Abbema, Tjan-Heijnen, Akker, and Buntinx(2015) suggest that, compared to middle-aged cancer patients,majority of older cancer patients have a high likelihood of usingcoping strategies of avoidance. These strategies are related to highrisk of depression. Furthermore, they stated that it is less likelyfor an older cancer patient to utilize active coping strategies,which is related to lower risk of depressive symptoms. The journal&quotDifferences in Coping Style and Locus of Control between Olderand Younger Patients with Head and Neck Cancer&quot from Derks,Leeuw, Hordijk, and Winnubst (2005) argues that both cancer patients,young and old who use avoidance coping are more likely to developdepressive symptoms that could lead to worse quality of life. Theresults presented by Kyriaki, Tsilika, Parpa, and Galanos (2015) inthe Psycho-Oncology Journal article &quotThe Influence of Sense ofControl and Cognitive Functioning in Older Cancer patients`depression&quot suggest that the level of depressive symptoms inolder cancer patients is determined by the sense of control duringthe &quotcause of the sickness&quot as well as during the &quotCourseof the illness&quot.

These articles imply that older adults with cancer apply some form ofcoping strategies and experience some locus of control that leads tohigh or low risks of developing depression. Moreover, they containsome useful information that can be used by researchers for futurereferences. In spite of that, each study has its weaknesses includingcontradiction, bias, and limitations.

The EvaluationMethods Utilized in each Study

There was a variation in methods and subjects used to evaluate eachof this study. However, all the articles led to almost the samefindings and conclusions. The constructs that were investigated weredepression, cognitive functioning, coping strategies, and locus ofcontrol.

The article “The influence of sense of control and cognitivefunctioning in older cancer patients` depression,&quot a sample ofone hundred and twelve cancer patients was collected but onlyeighty-six patients were studied to find out the prevalence ofdepressive symptoms in older patients with cancer (Kyriaki et al.,2015). The sample was collected from terminally ill cancer patientswho were above the age of sixty, who were in stage four of cancer,and who could give a written consent and communicate effectively. Allparticipants completed the cancer locus of control, fifteen itemGeriatric Depression Scale, and mini questionnaires related to mentalexamination (Kyriaki et al., 2015).

“Differences in coping style and locus of control between older andyounger patients with head and neck cancer” compared the prevalenceof depressive symptoms and quality of life to the locus of controland coping styles among a sample of younger patients and olderpatients who have the cancer of head and neck. Eligibility forinclusion in this study included patients with seventy or more yearsand patients between the age bracket of forty-five and sixty yearssuffering from newly diagnosed squamous cell carcinoma of theHypopharynx, oral cavity, and pharynx without distant metastasis(Derks et al., 2005). Within the duration of six to twelve months,fifty-one older and seventy younger patients were able to completequestionnaires on quality of life, depression, coping, and locus ofcontrol.

“The relation between depression, coping, and health locus ofcontrol: differences between older and younger patients, with andwithout cancer,” compared the prevalence of depression to healthlocus of control and coping strategies in old and middle-aged canceror noncancer patients. Eligibility for inclusion included cancerpatients above the age of seventy, newly diagnosed withgastrointestinal, prostate, breast, or lung cancer. The participantswere made to complete self-administered questionnaires or personalinterviews. Geriatric Depression Scale (GDS-15) was used to measuredepression, Utrecht Coping List (UCL) was used to measure the copingstrategy, and Multidimensional Health Locus of Control Scale tomeasure health locus of control (Aarts et al., 2015). The sample 1317participants were studied.

Results andOverall Conclusions of each Study

Kyriaki et al., (2015) found out that high level of depressivesymptoms correlated with a greater sense of control over the &quotcourseof illness.&quot Also, he found out that control over the &quotcauseof disease&quot was inversely related to the levels of depressivesymptoms. Compared to non-depressed patients, depressed patientsscored high in the orientation of the course of illness, and scoredlow in the orientation over the cause of sickness. There was nodifference in results found between depressed and non-depressedpatients for &quotcause of illness.&quot Multivariate analysisshowed that the probability of cancer patients using externalorientation in &quotcourse of illness&quot developing depressivesymptoms was high, whereas the likelihood of developing depressionwas low for those who utilized the external orientation in &quotcauseof illness.&quot Kyriaki et al., (2015) concluded that developmentof depressive symptoms was determined by the type of sense of controlutilized by an older cancer patient`s orientation over the course ofillness and cause of disease.

On the other hand, Derks et al., (2005) found no significantdifference in the quality of life scores and the number of depressivesymptoms among the older and young cancer patients before theystarted treatment and after one year. Also, findings indicated thatelderly patients were more likely to use religious control and copingstrategies while younger cancer patients were more likely to useactive coping strategies with more perceived internal control overthe disease cause. The study reported a high correlation betweencoping avoidance and high depressive symptoms. The study concludedthat there is no difference in levels of depression and quality oflife between the old and younger cancer patients in spite of the factthat they use divergent locus of control and coping strategies.

Aarts et al., (2015) findings demonstrated an overall of 12% indepression prevalence. Avoidance coping strategy was more prevalentin older cancer patients than in middle-aged patients. This copingstrategy was highly correlated with high levels of depressivesymptoms. Elderly patients were less likely to employ activestrategies that were positively related to lower levels of depression(Aarts et al., 2015) than middle-aged patients. Internal health locusand external locus of control were associated with higher and lowrisk of depressive symptoms respectively. The study concluded thatcoping strategies used by older cancer patients are different fromthose of other age groups, thus the reason behind high risk ofdepression in older patients with cancer (Aarts et al., 2015).


These three studies vary in rationale and popularity. All findingsare what many people would expect. All the studies implied that oldercancer patients are at a high risk of developing depressive symptomsif they use internal locus of control and avoidance coping strategiesto manage situations that are stressful. It seems logical thatdepression would be common in older adults with cancer due to theirinclination to avoidance coping strategies and internal locus ofcontrol. The use of graphs to clearly illustrate the concept ofdepression in older cancer patients shows that these articles areindeed relevant in the study of health problems in aging. All studiesemphasized on the instruments used to measure depression, the locusof control, and coping strategies in cancer patients.

Another significant aspect of these studies is that they tried to userepresentative samples of depressive cancer patients, and also usedcontrol groups of non-depressive and non-cancerous patients to fillthe gap of uncertainty on the prevalence of depression in oldercancer patients. Comparison between age groups was also demonstratedin Derk’s et al., (2005) and Aarts et al., (2015) studies wherethey compared depressive symptoms between the younger and oldercancer patients.


Aarts, J., Deckx,L., Abbema, D. L., Tjan-Heijnen, V. C., Akker, M. &amp Buntix, F.(2015). The relationbetween depression,coping andhealth locusof control:Differencesbetween olderand younger patients,with and without cancer.Psycho-Oncology, 24(8), 950-957.

Derks, W., de Leeuw,J. R. J., Hordijk, G. J., &amp Winnubst, J. A . M. (2005).Differences in coping style and locus of control between older andyounger patients with head and neck cancer. ClinicalOtolaryngology, 30(2), 186-192.

Kyriaki, M., Eleni,T., Efi, P., &amp Antonis, G. (2015). The influence of sense ofcontrol and cognitive functioning in older cancer patients`depression. Psycho-Oncology, 24: 311- 317.