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Trajectories of quality of life following cancer diagnostic and influencing factors in individuals aged 50 years old and above in Europe

par Kegne Ngnecheyi, Cyntia
Président du jury Donnen, Philippe
Promoteur Vanhoutte, Bram
Co-Promoteur Köhler, Thibault
Publication Non publié, 2024-06-19

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Résumé :

Introduction: The hedonic treadmill model has been widely used to illustrate individuals' trajectories in response to life events. However, when assessing the impact of a cancer diagnosis on well-being trajectories and quality of life, this model requires revision to fully understand the heterogeneity in these trajectories and the influence of various factors.Aim: The aim of our study was to identify distinct trajectories of well-being before and after a cancer diagnosis in individuals aged 50 years and above in Europe. We also sought to investigate the influence of socio-demographic and health-related factors on these trajectories. Methods: We analysed data from the longitudinal Survey of Health, Ageing, and Retirement in Europe (SHARE), focusing on waves 4 to 8. Our study included individuals aged 50 years and above with available information on quality of life (QoL) before and after a cancer diagnosis. We introduced a special time metric to focus on the cancer diagnosis and the periods before and after. Group-based trajectory modelling was used to identify different well-being trajectories, and multinomial logistic regression was employed to evaluate the relative risk ratio of belonging to a particular trajectory based on socio-economic and health-related factors.Results: We identified four distinct QoL trajectories: stable high level of QoL (39.2%), medium decreasing to increasing QoL (30.2%), medium decreasing QoL (24.3%), and low decreasing QoL (6.1%). Factors associated with these trajectories revealed that individuals in the highest tertile of wealth, those with a partner, and those with upper secondary and vocational training were significantly less likely to belong to the low decreasing trajectory compared to the stable high trajectory (Relative Risk Ratio = 0.11 [95% CI: 0.05-0.24], 0.58 [95% CI: 0.36-0.93], and 0.43 [95% CI: 0.27-0.7], respectively). Conversely, limitations in activities of daily living, fair or poor self-perceived health, and the presence of comorbidities increased the risk of belonging to the low decreasing QoL trajectory rather than the stable high QoL trajectory (RRR = 4.43, 8.88, and 3.26, respectively).Conclusion: The findings of our research indicate that, although the hedonic treadmill model is applicable to a subset of the population, there exists notable variation in the paths of well-being that are shaped by characteristics linked to health and socioeconomic status. Our findings highlight the significance of holistic approaches to patient treatment that address both sociodemographic and health-related aspects, in order to maximize well-being throughout the cancer journey.