Effect of a Dementia Diagnosis on Survival of Older Patients After a Diagnosis of Breast, Colon, or Prostate Cancer

Raji, Mukaila; Kuo, Yong Fang; Freeman, Jean L.; Goodwin, James S.

doi:10.1001/archinte.168.18.2033

Cited by 131 publications

(74 citation statements)

References 27 publications

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“…A large retrospective cohort study of patients aged >67 years who had preexisting dementia and had been diagnosed with breast, colon, or prostate cancer was carried out and published in 2008 by Raji et al [15]. They showed that preexisting dementia was associated with increased mortality, but mostly from noncancer-related cause [15].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Dementia in Older Adults with Solid Tumors

Wongrakpanich

Hurst²,

Bustamante³

et al. 2016

Dement Geriatr Cogn Disord

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Background: The public health burden of cancer and dementia in the geriatric population is well documented. There is limited data on how dementia predicts mortality among geriatric patients with solid tumors. The objective of this study is to determine the prognostic significance of dementia on survival in patients with solid tumors. Methods: We performed a 5-year retrospective study on elderly subjects aged ≥60 years with and without dementia that were diagnosed with solid tumors. Results: Among 3,460 patients with solid tumors, 132 (3.8%) patients were found to have dementia. The median age at diagnosis was 71 years. Kaplan-Meier curves demonstrated that patients with dementia had an inferior median survival compared to the nondemented group (30 vs. 56 months; log-rank p < 0.001). Cox proportional hazard regression modeling identified age >80 years, female gender, diabetes mellitus, congestive heart failure, atrial fibrillation, chronic obstructive pulmonary disease, chronic kidney disease, dementia, and radiation therapy as risk factors for decreased overall survival. Conclusions: We demonstrated that dementia is associated with shorter overall survival in elderly patients with solid tumors.

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Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Dementia in Older Adults with Solid Tumors

Wongrakpanich

Hurst²,

Bustamante³

et al. 2016

Dement Geriatr Cogn Disord

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“…70 SEER Medicare studies suggest that the estimated prevalence of dementia in cancer patients age 65 and over ranges from 3.8 to 7%, 71–73 although these estimates may be lower than true prevalence due to lack of reporting of these diagnoses within Medicare claims. 70 Few studies have examined how a prior diagnosis of MCI or dementia specifically impacts treatment decision-making for cancer and what percentage of these patients are offered various types of cancer therapies, such as surgery or chemotherapy.…”

Section: Risk Factors For Crcimentioning

confidence: 99%

“…72 Raji et al found that presence of a preexisting dementia diagnosis was associated with decreased survival after a diagnosis of breast, colon, or prostate cancer, increased mortality from cancer and from non-cancer causes, and increased odds of being diagnosed at an unknown stage of cancer. 73 The issue of providing cancer treatment to patients with pre-existing dementia is a complex balancing act in terms of considering quality of life vs. quantity of life for the patient, and certainly stage of dementia at the time of cancer diagnosis should be taken into consideration. However, further research on the overall benefits, risks, and tolerance of cancer treatment in dementia patients at different stages of cancer is needed to better inform treatment decision making for such patients and to better inform the role of health care professionals involved in the care of cancer patients with preexisting dementia.…”

Section: Risk Factors For Crcimentioning

confidence: 99%

Cognitive Effects of Chemotherapy and Cancer-Related Treatments in Older Adults

Vega

Dumas

Newhouse

2017

The American Journal of Geriatric Psychiatry

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Advances in cancer treatment are producing a growing number of cancer survivors; therefore, issues surrounding quality of life during and following cancer treatment have become increasingly important. Chemotherapy-related cognitive impairment (CRCI) is a problem that is commonly reported following the administration of chemotherapy treatment in patients with cancer. Research suggests that CRCI can persist for months to years after completing treatment, which has implications for the trajectory of normal and pathologic cognitive aging for the growing number of long-term cancer survivors. These problems are particularly relevant for older individuals given that cancer is largely a disease of older age, and the number of patients with cancer who are age 65 years or older will increase dramatically over the coming decades. This review will briefly summarize empirical findings related to CRCI, discuss CRCI in older patients with cancer, potential causative hypotheses, and provide a canonical patient case to illustrate how CRCI presents clinically. Finally, potential intervention strategies for CRCI will be highlighted and issues to consider when evaluating older patients with a history of cancer will be discussed.

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“…4 Because mild cognitive impairment (MCI) or dementia is already fairly prevalent in older patients at the time of cancer diagnosis, this represents a challenge in studying the role that cancer diagnosis and cancer treatment may play in the exacerbation of cancer-related cognitive impairment in older adults. SEER Medicare studies suggest that the estimated prevalence of dementia in cancer patients age 65 and over ranges from 3.8% to 7%, 5–7 although this is likely lower than the true prevalence due to lack of capture of these diagnoses within Medicare claims. It is unknown how a prior diagnosis of dementia or MCI specifically impacts treatment decision making for cancer and what percentage of these patients with pre-existing cognitive impairments are offered various types of cancer therapies, such as surgery or chemotherapy.…”

Section: Introductionmentioning

confidence: 99%

Cognition and Cognitive Impairment in Older Adults with Cancer

2016

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Aging is a risk factor for cognitive impairment as well as cancer. However, the interplay between these three entities – aging, cognition and cancer – is not well understood. Mounting evidence indicates that both cancer and cancer therapies, such as chemotherapy, can negatively affect cognition and that older adults with pre-existing cognitive impairment may be more susceptible to cognitive decline with therapy than younger patients. For an older adult, decline in cognition may significantly compromise their ability to remain independent in the community. Pre-existing cognitive impairment, at the time of a cancer diagnosis, may also carry an increased risk of treatment-related adverse events in older adults receiving chemotherapy. Growing research suggests behavioral interventions may be helpful in improving chemotherapy-related cognitive changes; however, these interventions have been mainly evaluated in younger patients in whom pre-existing cognitive impairment is less prevalent. Here we review the studies on: cognitive changes associated with cancer and cancer therapies with an emphasis on studies conducted in older adults, relevant screening tools to evaluate cognition in the geriatric oncology setting, and possible intervention strategies for managing cognitive impairment.

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Effect of a Dementia Diagnosis on Survival of Older Patients After a Diagnosis of Breast, Colon, or Prostate Cancer

Cited by 131 publications

References 27 publications

Prognostic Significance of Dementia in Older Adults with Solid Tumors

Prognostic Significance of Dementia in Older Adults with Solid Tumors

Cognitive Effects of Chemotherapy and Cancer-Related Treatments in Older Adults

Cognition and Cognitive Impairment in Older Adults with Cancer

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