Cognitive impairment and dementia in older cancer patients.

Abstract

e269 Background: Chemotherapy effect on cognitive function has also been described in women with breast cancer. Our objective was to define the prevalence of cognitive impairment and dementia in older patients with cancer. Methods: This is a retrospective study at the Program for Healthy Aging at MD Anderson Cancer Center between January 1, 2013 and March 31, 2015. Patients with cancer, 65 years of age and older underwent functional and cognitive testing through personal interview, using IADLs, ADLs, and the Montreal cognitive assessment (MOCA). Screening for depression used PHQ-9. Risk factors for dementia assessed, included depression, concussions, alcohol abuse, and family history of dementia. Level of education was determined. Cognitive impairment was diagnosed with an abnormal MOCA ( < 26) without functional impairment, dementia was diagnosed with an abnormal MOCA with functional impairment. Imaging and assessment for reversible factors of memory loss was conducted. SAS 9.4 (SAS Institute INC, Cary, NC) was used for data analysis. Results: 192 patients were evaluated, male gender (n = 93, 48.4%), female (n = 99, 51.6%), mean age 78 years old (SD, 7) range 65 to 94 years. Sixty-two patients (32.3%) with a hematological malignancy; 26 (13.5%) with breast cancer; 22 (11.5%) with GI cancer; 19 (9.9%) with prostate malignancy; 16 (8.3%) with lung cancer; 14 (7.3%) with bladder cancer; and 33 (17.2%) with other malignancies. Cognitive impairment and/or dementia was identified in 118 (61.5%) patients. Mild cognitive impairment was evidenced in 27 cases (18.2%). Types of dementia included Alzheimer’s disease (n = 11, 7.4%), vascular dementia (n = 21, 14.2%), and mixed dementia (n = 59, 39.9%). The majority of cases of dementia were early stage dementia (n = 45, 56.3%), moderate stage dementia (n = 29, 36.3%), and advanced or severe dementia (n = 6, 7.5%). No significant thyroid abnormalities, B12 deficiency or other reversible causes were identified. Conclusions: Cognitive impairment and/or dementia are commonly seen in patients with cancer in a comprehensive cancer center. Further research in this area is necessary.