Naeim A, Reuben D
Division of Hematology-Oncology, Department of Medicine, Los Angeles Medical Center, UCLA School of Medicine, CA 90024, USA.
Oncology (Williston Park). 2001 Dec;15(12):1567-77, 1580; discussion 1581, 1586, 1591.
Older individuals are at risk for adverse events in all settings where cancer is treated. Common geriatric syndromes can complicate cancer therapy, and thus, increase patient morbidity and the costs of care. Furthermore, cancer treatment can worsen geriatric syndromes. It is often difficult to determine whether declining health is a result of cancer treatment or the patient's underlying disease. Baseline assessment of multiple factors may facilitate detection of a decline in the patient's health status, which may be remediable. Geriatric syndromes may substantially affect quality of life and are also important in the prognosis and outcome of cancer therapy. This article reviews the assessment of cognitive syndromes (dementia and delirium), vision and hearing impairment, gait and balance difficulties, malnutrition, incontinence, depression, osteoporosis, sleep disorders, environmental and social issues, and functional decline. Although there are many geriatric domains and many focused assessment tools, assessment does not need to be time-consuming. Streamlined assessment tools have been developed; they are brief, inexpensive, and easily administered, and they may be valuable to the oncologist. Staff such as nurses, social workers, or office personnel could perform these assessments and minimize the impact on the physician's time.
在所有癌症治疗环境中，老年人都面临不良事件的风险。常见的老年综合征会使癌症治疗复杂化，从而增加患者的发病率和护理成本。此外，癌症治疗会使老年综合征恶化。通常很难确定健康状况下降是癌症治疗的结果还是患者潜在疾病所致。对多种因素进行基线评估可能有助于发现患者健康状况的下降，而这种下降可能是可以补救的。老年综合征可能会严重影响生活质量，对癌症治疗的预后和结果也很重要。本文综述了对认知综合征（痴呆和谵妄）、视力和听力障碍、步态和平衡困难、营养不良、失禁、抑郁、骨质疏松、睡眠障碍、环境和社会问题以及功能衰退的评估。尽管有许多老年领域和许多针对性的评估工具，但评估并不需要耗费大量时间。已经开发出了简化的评估工具；它们简短、廉价且易于实施，对肿瘤学家可能很有价值。护士、社会工作者或办公室人员等工作人员可以进行这些评估，并尽量减少对医生时间的影响。
