Prevalence of pre-existing cognitive impairment in patients treated for cancer and the impact of cancer treatment on cognitive outcomes: A scoping review

IF 3 3区医学 Q3 GERIATRICS & GERONTOLOGY

Journal of geriatric oncology Pub Date : 2025-03-30 DOI:10.1016/j.jgo.2025.102235

Nelly Toledano , Valentina Donison , Avital Sigal , Samantha Mayo , Shabbir M.H. Alibhai , Martine Puts

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引用次数: 0

Abstract

Introduction

Pre-existing cognitive impairment (CI) is likely underreported in patients treated for cancer, and its prevalence remains unclear. Older adults with CI may have a greater risk of treatment failure and increased morbidity and mortality than patients with intact cognition. To our knowledge, there has not been a previous review summarizing data on the prevalence of pre-existing CI in patients with cancer. This review addresses: (1) What is the prevalence of pre-existing CI in patients treated for cancer and (2) What is the impact of cancer treatment on cognitive outcomes among patients exhibiting pre-existing CI before planned cancer treatment?

Materials and Methods

We defined CI as a diagnosis of dementia or mild or unspecified CI before any cancer treatment, including surgery. This scoping review followed the Arksey and O'Malley framework and adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. Two reviewers independently screened titles, abstracts, and full-text articles, resolving disagreements with a third reviewer. The reviewers systematically searched MEDLINE, Excerpta Medica Database (EMBASE), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) from inception until July 15, 2023, including original research focused on participants aged 60 or older reporting the prevalence of pre-existing CI before any cancer treatment.

Results

Among the 10,490 screened citations, 23 manuscripts reporting on 21 studies met the inclusion criteria for both review questions. Pre-existing CI was prevalent at a mean rate of 6 % in administrative database studies, while clinical studies employing pre-treatment cognitive screening tools, primarily the Mini-Mental State Examination and Mini-Cog, reported a higher mean prevalence of 26 % (range 2.6 to 52 %). Only one study reported postoperative delirium in 27.9 % of patients with CI following cancer surgery, suggesting a higher risk of delirium in this population. However, none of the reviewed studies provided data on other cognitive outcomes, such as chemotherapy-related CI or treatment toxicity, in these individuals.

Discussion

Pre-existing CI is common but highly variable. The variability in reported prevalence rates can largely be attributed to significant differences in study inclusion criteria of participants and sample size, with some studies relying on regionally limited datasets.

查看原文本刊更多论文

接受癌症治疗的患者原有认知障碍的普遍程度以及癌症治疗对认知结果的影响：范围界定综述

在接受癌症治疗的患者中，预先存在的认知障碍（CI）可能被低估了，其患病率尚不清楚。与认知完整的患者相比，老年CI患者治疗失败的风险更大，发病率和死亡率更高。据我们所知，之前还没有一篇综述总结了癌症患者中既往CI患病率的数据。本综述探讨：(1)在接受癌症治疗的患者中，既往CI的患病率是多少；(2)在计划的癌症治疗前，癌症治疗对存在既往CI的患者的认知结局有何影响？材料和方法我们将CI定义为在任何癌症治疗（包括手术）前诊断为痴呆或轻度或未明确CI。该范围评价遵循Arksey和O'Malley框架，并遵循系统评价的首选报告项目和范围评价的元分析扩展指南。两位审稿人独立筛选标题、摘要和全文文章，解决与第三位审稿人的分歧。研究者系统地检索了MEDLINE、医学摘录数据库（EMBASE）和护理与相关健康文献累积索引（CINAHL），检索时间从研究开始到2023年7月15日，包括针对60岁及以上参与者的原始研究，这些参与者报告了任何癌症治疗前已有CI的患病率。结果在10490篇被筛选的引文中，有23篇报道21项研究的论文符合两个综述问题的纳入标准。在行政数据库研究中，已有CI的平均发生率为6%，而采用治疗前认知筛查工具的临床研究，主要是Mini-Mental State Examination和Mini-Cog，报告的平均患病率较高，为26%（范围为2.6%至52%）。只有一项研究报告了27.9%的CI患者在癌症手术后出现谵妄，这表明该人群出现谵妄的风险更高。然而，在这些研究中，没有一项研究提供了其他认知结果的数据，如化疗相关CI或治疗毒性。预先存在的CI很常见，但变化很大。报告患病率的差异在很大程度上可归因于参与者的研究纳入标准和样本量的显著差异，一些研究依赖于区域有限的数据集。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of geriatric oncology ONCOLOGY-GERIATRICS & GERONTOLOGY

CiteScore

5.30

自引率

10.00%

发文量

379

审稿时长

80 days

期刊介绍： The Journal of Geriatric Oncology is an international, multidisciplinary journal which is focused on advancing research in the treatment and survivorship issues of older adults with cancer, as well as literature relevant to education and policy development in geriatric oncology. The journal welcomes the submission of manuscripts in the following categories: • Original research articles • Review articles • Clinical trials • Education and training articles • Short communications • Perspectives • Meeting reports • Letters to the Editor.