Understanding the onset of high worry during chemotherapy: implications for age-specific psychosocial care

Purpose To examine whether middle-aged and older adults differ in a) the timing or onset of high worry and b) the proportion remaining free of high worry throughout chemotherapy, and to identify age-specific predictors.Methods This is a secondary analysis of a longitudinal randomized controlled trial (Managing at Home). Survival analysis with Kaplan–Meier (KM) method compared rates of high worry across six times between age groups. Cox proportional hazards models were fit within each group to identify predictors of high worry, adjusting for other covariates.Results Among 299 participants, most high worry occurred at T1. Across time points, older adults (n = 171) consistently showed a higher proportion remaining free of high worry than middle-aged adults (n = 117). Distinct predictors of high worry emerged for each group.Conclusion These findings highlight the importance of early, multidimensional assessment and support age-specific supportive care strategies to identify and manage patients at risk for persistent worry.