The association between dispositional optimism and functioning and quality of life in older patients 12 months after cancer diagnosis: a multicentre cohort study

Abstract Background The impact of cancer diagnosis and treatment on patients’ well-being is significant and personality traits such as optimism may play an important role in bearing difficulties and physical recovery. This study examined the association between dispositional optimism and changes in physical functioning and quality of life 12 months after cancer diagnosis. Methods The study included patients aged ≥70 years with cancer before treatment initiation. Associations between dispositional optimism at baseline and a combined endpoint, defined as changes in physical functioning (ADL/IADL) or quality of life (EQ-5D/EQ-VAS) and/or mortality at 12 months were analysed using uni- and multivariable logistic regression. Results We included 1,168 patients with a median age of 77 (IQR 73–82) years, of whom 49% were female. Screening with the Geriatric-8 showed risk of frailty in 75% of patients. Dispositional optimism, present in 70% of patients, was associated with preserved or improved IADL (OR 1.68, CI 1.22–2.31), EQ-5D (OR 1.72, CI 1.21–2.45) and EQ-VAS (OR 1.57, CI 1.11–2.23), and 7.2% lower mortality at 12 months. This was independent of age, gender, treatment intent, frailty, baseline functioning and quality of life. Conclusion Dispositional optimism is associated with preserved or improved physical functioning and quality of life as well as reduced mortality 12 months after cancer diagnosis in older patients. Further research is needed to understand the role of optimism in coping with cancer, treatment, recovery and resilience which could lead to developing and evaluating interventions that increase optimism.