Vinckier C, de Nooijer K, Smets T, Du Cheyne H, Decoster L, Van den Block L. Changes in quality of life throughout the illness trajectory of older adults with cancer: a systematic review. Oncologist. 2025 Jul 23:oyaf223. doi: 10.1093/oncolo/oyaf223.
Abstract
Background: Older adults with cancer often experience frailty and comorbidities, potentially impacting their quality of life. Knowledge on quality-of-life changes throughout the cancer trajectory is important to set feasible expectations in interventions or trials.
Aim: This systematic review synthesizes existing knowledge on quality-of-life changes in older adults with cancer throughout their illness trajectory, and explores potential individual, relational, community, and societal factors associated with these changes.
Method: We systematically searched PubMed, Embase and PsycINFO. We synthesized characteristics and outcomes of all studies reporting on quality-of-life or well-being changes in people aged 65+ with cancer. We used Bronfenbrenner's Social Ecological Model to categorize associated factors. We followed PRISMA guidelines and registered in PROSPERO (CRD42024566815).
Results: We included 22 studies. Studies varied in characteristics of the cohorts and timing of the measurements and were often lacking clear quality-of-life conceptualizations. All studies used a quantitative design, except 1 mixed-methods study. Eight of 9 studies with follow-up moments of 12 months or more reported stable quality-of-life scores. All 3 studies examining the last year of life found quality-of-life declines. Five other studies reported a decline during treatment; in 4 studies followed by an increase. Comorbidities, older age and mobility problems were most frequently associated with declining quality of life. Relational, community and societal level factors were rarely studied.
Conclusion: Despite the methodological heterogeneity between studies, we identified trends in quality-of-life changes across the illness trajectories of older adults with cancer, particularly declining trends during treatment and end-of-life periods and stable trends in long-term follow-up.
Keywords: aged; longitudinal studies; neoplasms; quality of life; systematic review; trends.
© The Author(s) 2025. Published by Oxford University Press.
