实体肿瘤老年患者中痴呆的预后意义

Prognostic Significance of Dementia in Older Adults with Solid Tumors.

作者信息

Wongrakpanich Supakanya, Hurst Amy, Bustamante Jean, Candelario Nellowe, Biso Sylvia, Chaiwatcharayut Wikrom, Dourado Claudia, Rosenzweig Andrew

机构信息

Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA.

出版信息

Dement Geriatr Cogn Disord. 2017;43(1-2):38-44. doi: 10.1159/000453449. Epub 2016 Dec 16.

DOI:10.1159/000453449

PMID:27978516

Abstract

BACKGROUND

The public health burden of cancer and dementia in the geriatric population is well documented. There is limited data on how dementia predicts mortality among geriatric patients with solid tumors. The objective of this study is to determine the prognostic significance of dementia on survival in patients with solid tumors.

METHODS

We performed a 5-year retrospective study on elderly subjects aged ≥60 years with and without dementia that were diagnosed with solid tumors.

RESULTS

Among 3,460 patients with solid tumors, 132 (3.8%) patients were found to have dementia. The median age at diagnosis was 71 years. Kaplan-Meier curves demonstrated that patients with dementia had an inferior median survival compared to the nondemented group (30 vs. 56 months; log-rank p < 0.001). Cox proportional hazard regression modeling identified age >80 years, female gender, diabetes mellitus, congestive heart failure, atrial fibrillation, chronic obstructive pulmonary disease, chronic kidney disease, dementia, and radiation therapy as risk factors for decreased overall survival.

CONCLUSIONS

We demonstrated that dementia is associated with shorter overall survival in elderly patients with solid tumors.

摘要

背景

癌症和痴呆症在老年人群中的公共卫生负担已有充分记录。关于痴呆症如何预测老年实体瘤患者死亡率的数据有限。本研究的目的是确定痴呆症对实体瘤患者生存的预后意义。

方法

我们对年龄≥60岁、患有和未患有痴呆症且被诊断为实体瘤的老年受试者进行了一项为期5年的回顾性研究。

结果

在3460例实体瘤患者中，发现132例（3.8%）患者患有痴呆症。诊断时的中位年龄为71岁。Kaplan-Meier曲线表明，与非痴呆组相比，痴呆症患者的中位生存期较差（30个月对56个月；对数秩检验p<0.001）。Cox比例风险回归模型确定年龄>80岁、女性、糖尿病、充血性心力衰竭、心房颤动、慢性阻塞性肺疾病、慢性肾病、痴呆症和放射治疗是总体生存率降低的风险因素。