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Association between a cognitive screening test and severe chemotherapy toxicity in older adults with cancer.

ABSTRACT: INTRODUCTION:Cognitive impairment (CI) increases chemotherapy toxicity risk with need to understand this association utilizing publicly available short screening tools. We evaluated this utilizing a lower threshold on a short screening tool in older adults with cancer. MATERIALS AND METHODS:We analyzed data from the Cancer and Aging Research Group (CARG) Chemotherapy Toxicity Risk tool (CARG score) development and validation cohorts (n?=?703), which recruited adults age???65 with cancer from academic centers. Cognition was evaluated with the Blessed Orientation-Memory-Concentration test (BOMC). Patients with BOMC score???11 were excluded. Utilizing cut-points for older adults, we considered moderate BOMC scores (5-10) as potential CI. Logistic regression was used for analysis. RESULTS:Patient baseline characteristics included: mean age 73; 85% white; 63% college or higher education; 250 (36%) potential CI; 385 (55%) severe toxicity. Patients with potential CI were more likely non-white (p???0.01) and to have high school or lower education (p???0.01) and high CARG score (p?=?0.04). Potential CI was associated with increased severe toxicity risk (OR?=?1.54, p???0.01). After adjusting for CARG score, this association became nonsignificant (OR?=?1.35; p?=?0.08). Among patients with lower education (n?=?258; 36.7%), potential CI remained associated with severe toxicity, even after adjusting for CARG score (OR?=?1.87, p?=?0.03). CONCLUSIONS:Our findings suggest potential cognitive impairment, defined by BOMC score 5-10, in older adults with cancer and lower education is associated with increased severe toxicity risk. Future studies are needed to validate these findings. Healthcare providers should consider cognitive testing before treatment for these vulnerable patients.

SUBMITTER: Jayani RV

PROVIDER: S-EPMC7054133 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Association between a cognitive screening test and severe chemotherapy toxicity in older adults with cancer.

Jayani Reena V RV Magnuson Allison M AM Sun Can-Lan CL Ma Huiyan H Tew William P WP Mohile Supriya G SG Gajra Ajeet A Klepin Heidi D HD Gross Cary P CP Muss Hyman B HB Chapman Andrew E AE Katheria Vani V Hurria Arti A Dale William W

Journal of geriatric oncology 20191206 2

<h4>Introduction</h4>Cognitive impairment (CI) increases chemotherapy toxicity risk with need to understand this association utilizing publicly available short screening tools. We evaluated this utilizing a lower threshold on a short screening tool in older adults with cancer.<h4>Materials and methods</h4>We analyzed data from the Cancer and Aging Research Group (CARG) Chemotherapy Toxicity Risk tool (CARG score) development and validation cohorts (n = 703), which recruited adults age ≥ 65 with ...[more]

PMID: 31813840

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Project description:ImportanceRetinal layer thickness is hypothesized to be related to cognitive function in patients with mild cognitive impairment (MCI) and Alzheimer disease (AD). However, longitudinal cohort studies of the healthy older population are scarce.ObjectiveTo investigate the association between retinal layer thickness and cognitive impairment and future cognitive decline in a community-based population cohort.Design, setting, and participantsA total of 430 randomly sampled community-dwelling Korean individuals 60 years or older participated in the baseline assessment (mean [SD], 76.3 [6.6] years) 215 of whom completed a mean (SD) of 5.4 (0.6) years (range, 4.1-6.2 years) of follow-up. Using spectral-domain optical coherence tomography, the study team assessed the thickness of 6 retinal layers in the macular region, the peripapillary retinal nerve fiber layers (RNFLs), and the subfoveal choroid at baseline.ExposuresAge, sex, education, diabetes, hypertension, and apolipoprotein E4 gene status.Main outcomes and measuresRetinal layer thickness and cognitive function test scores were analyzed.ResultsThis study included 430 participants (female, 208 [48.6%]). Baseline macular RNFL thickness was associated with baseline Consortium to Establish a Registry for Alzheimer's Disease (CERAD) score (coefficient [β] = 0.077; 95% CI, 0.054-0.100; P = .04 for total macular area) and Mini-Mental State Examination (MMSE) score (coefficient [β] = 0.082; 95% CI, 0.063-0.101; P = .03 for total macular area). A thinner baseline total macular RNFL thickness (lowest quartile, <231 μm) was associated with a larger decline in the CERAD and MMSE scores during the follow-up period (P = .003 and P = .01, respectively). Furthermore, participants with baseline total macular RNFL thickness below the lowest quartile cutoff value presented a greater decline in cognitive scores and a higher prevalence of cognitive impairment and Alzheimer disease than those with RNFL thickness above the lowest quartile cutoff value.Conclusions and relevanceIn this study, macular RNFL thickness could be used as a prognostic biomarker of long-term cognitive decline in adults 60 years or older. However, to confirm these results, further large-scale population-based studies should be performed.

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Dataset Information

Association between a cognitive screening test and severe chemotherapy toxicity in older adults with cancer.

Publications

Association between a cognitive screening test and severe chemotherapy toxicity in older adults with cancer.

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