Influence of aging, comorbidities, and chemotherapy on dementia in patients with metastatic cancer.

Abstract

e23097 Background: Studies highlight cognitive decline in cancer survivors, exploring treatment-linked neurodegeneration risks. Yet, the effects of aging (age), comorbidities, and chemotherapy on dementia in metastatic patients are unclear. Methods: US Trauma Quality Program (2017-2019) for 17,940 metastatic cancer patients was analyzed. Our outcome was dementia diagnosis in metastatic cancer patients (no/yes). Independent variables were patient’s age (younger adults aged 18-55 years and seniors ≥56 years), any comorbid condition (yes/no), and received chemotherapy (yes/no). Covariates included sex, payment type, verification level, injury intent, mechanism, injury place, and Injury Severity Score. We used Stata.v18 for descriptive statistics, chi-square, and logistic regression with statistical significance at p≤0.05. Results: Of the 17,940 patients, 7.9% had dementia. Seniors had higher dementia rate than younger adults (98.9% vs. 1.1%; p < 0.001). Most dementia patients had comorbidities (89.4%, p < 0.001). Chemotherapy recipients had a lower dementia rate than those untreated (8.9% vs. 91.1%; p < 0.001). In the adjusted analyses, seniors than younger adults (OR: 4.51, 95% CI: 2.38 - 8.56) and any comorbidities (OR: 1.33 ,95% CI: 1.07 - 1.65) exhibited higher odds of dementia. Notably, chemotherapy recipients had decreased odds of dementia than those untreated (OR: 0.42, 95% CI: 0.34 - 0.53). Conclusions: Metastatic cancer patients of older age and comorbidities had increased risk of dementia. Chemotherapy remarkably lowered this risk. This should guide clinicians in managing dementia risk. [Table: see text]