Abstract
e24019 Background: Normal aging is associated with a decline in neurocognitive abilities. Regardless of age, 42% to 91% of persons with cancer and brain metastases are reported to have neurocognitive impairment. There are no data regarding the prevalence of cognitive impairment in older persons with cancer and brain metastasis. Methods: This retrospective analysis was performed on a prospectively collected dataset of patients who attended the geriatric oncology clinic at the Tata Memorial Hospital, a tertiary-care comprehensive cancer center in India from June 2018 to February 2021. Patient aged 60 years and over with malignancy were included. Cognition was assessed with the mini-mental status examination (MMSE); the Hindi MMSE was used for illiterate patients. A score of < 23 on the MMSE was considered abnormal. Correlation between the presence of cognitive impairment and brain metastases was tested using the chi-square test. Results: A total of 401 patients were included, of which 318 (79.3%) were males. The median age was 70 years (range: 60-100 years). All patients had solid tumors; 162 (40.4%) had lung, 139 (34.7%) had gastrointestinal and 48 (12%) had head and neck malignancies. Twenty-five (6.2%) patients had brain metastases, of which 5 (20%) had solitary, 19 (76%) had multiple lesions, and 1 (4%) had leptomeningeal metastases. Cognitive impairment was noted in 4 (16%) of the 25 patients with brain metastases and 61 (16.2%) out of 376 patients without brain metastases. There was no significant correlation between the presence of brain metastases and cognitive impairment, p = 0.57. Conclusions: Older persons with cancer and brain metastases do not have a higher incidence of cognitive impairment than those without brain metastases. The next step is to understand whether older persons with brain metastases are more at risk for cognitive decline as a result of therapeutic interventions such as cranial radiotherapy and chemotherapy.
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