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癌症老年患者中报告的听力和视力障碍与功能、心理和认知状况之间的关联。

Association between patient-reported hearing and visual impairments and functional, psychological, and cognitive status among older adults with cancer.

机构信息

Cancer and Aging Research Program, City of Hope, Duarte, California.

Department of Geriatrics, Salvador Zubiran National Institute of Medical Science and Nutrition, Mexico City, Mexico.

出版信息

Cancer. 2018 Aug 1;124(15):3249-3256. doi: 10.1002/cncr.31540. Epub 2018 May 24.

Abstract

BACKGROUND

Hearing and visual impairments are common among community-dwelling older adults, and are associated with psychological, functional, and cognitive deficits. However, to the authors' knowledge, little is known regarding their prevalence among older patients with cancer.

METHODS

The current study was a secondary analysis combining 2 prospective cohorts of adults aged ≥65 years with solid tumors who were receiving chemotherapy. The authors assessed the association between patient-reported hearing and/or visual impairment (defined as fair/poor grading by self-report) and physical function, instrumental activities of daily living (IADLs), anxiety, depression, and cognition. Descriptive analyses were conducted to summarize patient and treatment characteristics. One-way analysis of variance and chi-square tests were conducted as appropriate to examine differences between patients with and without sensory impairments. Logistic regression was used to analyze associations between sensory impairments and outcomes.

RESULTS

Among 750 patients with a median age of 72 years who had solid tumors (29% with breast/gynecological tumors, 28% with lung tumors, and 27% with gastrointestinal tumors), approximately 18% reported hearing impairment alone, 11% reported visual impairment alone, and 7% reported dual sensory impairment. Hearing impairment was associated with IADL dependence (odds ratio [OR], 1.9), depression (OR, 1.6), and anxiety (OR, 1.6). Visual impairment was associated with IADL dependence (OR, 1.9), poor physical function (OR, 1.9), and depression (OR, 2.5). Dual impairment was associated with IADL dependence (OR, 2.8), anxiety (OR, 2.3), depression (OR, 2.5), and cognitive impairment (OR, 3.2).

CONCLUSIONS

Sensory impairment is common among older adults with cancer. Patients with sensory impairment are more likely to have functional, psychological, and cognitive deficits. Interventions aimed at improving the vision and hearing of older adults with cancer should be studied. Cancer 2018. © 2018 American Cancer Society.

摘要

背景

听力和视力障碍在社区居住的老年人中很常见,与心理、功能和认知缺陷有关。然而,据作者所知,很少有关于癌症老年患者中这些障碍的患病率的报道。

方法

本研究是对 2 个年龄≥65 岁的接受化疗的实体瘤成年患者前瞻性队列的二次分析。作者评估了患者报告的听力和/或视力障碍(自我报告为“差/极差”分级)与身体功能、工具性日常生活活动(IADLs)、焦虑、抑郁和认知之间的关联。采用描述性分析总结患者和治疗特征。采用方差分析和卡方检验(适当情况下)比较有和无感觉障碍患者之间的差异。采用逻辑回归分析感觉障碍与结局之间的关联。

结果

在 750 名中位年龄为 72 岁的患有实体瘤的患者中(29%为乳腺/妇科肿瘤,28%为肺部肿瘤,27%为胃肠道肿瘤),约 18%单独报告听力障碍,11%单独报告视力障碍,7%报告双重感觉障碍。听力障碍与 IADL 依赖(比值比 [OR],1.9)、抑郁(OR,1.6)和焦虑(OR,1.6)相关。视力障碍与 IADL 依赖(OR,1.9)、身体功能不佳(OR,1.9)和抑郁(OR,2.5)相关。双重障碍与 IADL 依赖(OR,2.8)、焦虑(OR,2.3)、抑郁(OR,2.5)和认知障碍(OR,3.2)相关。

结论

感觉障碍在老年癌症患者中很常见。有感觉障碍的患者更有可能存在功能、心理和认知缺陷。应研究旨在改善老年癌症患者视力和听力的干预措施。癌症 2018;124:3300-10. ©2018 美国癌症协会。

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