Isenberg-Grzeda Elie, Huband Helen, Lam Henry
aDepartment of Psychiatry, University of Toronto bOdette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario cDalhousie University, Halifax, Nova Scotia dLibrary Services, Sunnybrook Health Sciences Centre, Toronto, Ontario.
Curr Opin Support Palliat Care. 2017 Mar;11(1):24-31. doi: 10.1097/SPC.0000000000000257.
Cancer-related cognitive impairment (CRCI) is highly prevalent, and assessment of cognition is crucial in providing optimal cancer care. Neuropsychological assessment (NPA) can be lengthy and expensive. Cognitive screening tools are plenty but validity has not been thoroughly studied for use in cancer patients.
Our search of the recent literature revealed that the Montreal Cognitive Assessment, Mini-Mental State Examination, and Clock Draw Test were the most frequently studied objective screening tools. The Functional Assessment of Cancer Therapy-Cognitive Function and the Cognitive Symptom Checklist-Work 21 were the most commonly studied subjective measures of perceived cognitive impairment. Evidence supports using the Montreal Cognitive Assessment or the Clock Draw Test over the Mini-Mental State Examination to screen for cognitive impairment within specific patient populations. In addition, adding a subjective measure of cognitive impairment (e.g., Functional Assessment of Cancer Therapy-Cognitive Function) may increase diagnostic sensitivity.
These suggest that cognitive screening tools may have a role in screening for CRCI, particularly when full NPA is not feasible. Researchers must continue to conduct high-quality studies to build an evidence to guide best practices in screening for CRCI.
癌症相关认知障碍(CRCI)非常普遍,认知评估对于提供最佳癌症护理至关重要。神经心理学评估(NPA)可能耗时且昂贵。认知筛查工具众多,但在癌症患者中的有效性尚未得到充分研究。
我们对近期文献的检索显示,蒙特利尔认知评估、简易精神状态检查表和画钟测试是研究最频繁的客观筛查工具。癌症治疗认知功能功能评估量表和认知症状清单-工作版21是最常研究的关于感知认知障碍的主观测量方法。有证据支持在特定患者群体中使用蒙特利尔认知评估或画钟测试而非简易精神状态检查表来筛查认知障碍。此外,增加认知障碍的主观测量方法(如癌症治疗认知功能功能评估量表)可能会提高诊断敏感性。
这些表明认知筛查工具可能在CRCI筛查中发挥作用,特别是在全面NPA不可行时。研究人员必须继续进行高质量研究,以建立证据来指导CRCI筛查的最佳实践。