Self-perceptions of age among 292 chemotherapy-treated cancer patients: Exploring associations with symptoms and survival

Objective: A growing literature suggests that older individuals who report feeling younger than their actual chronological age enjoy better health and survival. The purpose of this study was to explore similar associations in patients with cancer. Methods: Chemotherapy-treated cancer patients completed a previously-validated questionnaire item on their self-perception of age. Concurrent patient-reported number of symptoms and pain severity were recorded. In addition, baseline and longitudinal data captured demographics and vital status, respectively. Results: Among 292 patients, 185 (63%) reported that they perceived themselves as younger than their actual age, 45 as older (15%), and 56 (19%) as the same age (unable to be determined in 6). The mean actual chronological age (standard deviation) among those who perceived themselves as younger, older, or the same age was 63. years (11), 54 (12), and 60 (10); (p < 0.0001). An inverse relationship was observed between self-perceived age and actual age (odds ratio 1.05 with 95% confidence interval of 1.02, 1.07; p = 0.0001) but, otherwise, no statistically significant relationships were observed with gender, cancer curability potential, number of symptoms, or pain severity. Improved survival was associated with fewer symptoms and the potential for curing the cancer, but not with patients' age perceptions. Qualitative themes such as positive thinking, staying engaged with life, the importance of family, and maintaining a sense of humor emerged among those who felt younger. Conclusion: A substantial percentage of patients with cancer - particularly older ones - report feeling younger than their actual age; this perception appears to have no relevance to symptoms or survival.