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

Objective: 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. Aim: 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. Methods: 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). Results: 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. Conclusions: 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.