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老年非霍奇金淋巴瘤长期幸存者认知能力下降:一项多中心横断面研究。

Cognitive decline in older long-term survivors from Non-Hodgkin Lymphoma: a multicenter cross-sectional study.

机构信息

Fondazione ANT Italia Onlus, Delegazione di Firenze, Florence, Italy.

Department of Geriatrics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.

出版信息

J Geriatr Oncol. 2020 Jun;11(5):790-795. doi: 10.1016/j.jgo.2020.01.007. Epub 2020 Jan 31.

Abstract

OBJECTIVES

To compare cognition in a group of older long-term survivors from Non-Hodgkin Lymphoma (NHL) and in a corresponding group of non-cancer controls of the same age. Functional status, polypharmacy and multimorbidity were also evaluated.

METHODS

A cross-sectional study was performed in a population of 63 outpatient long-term survivors from NHL, aged 65 or more and 61 non-cancer controls. Socio-demographic, clinical and functional data were collected. Cognitive function was assessed through neuropsychological tests.

RESULTS

NHL survivors showed a slightly worse functional status than controls, they were affected by more chronic conditions (3.4 vs 2.3; p = .003) and were taking a higher number of medications (3.4 vs 2.3; p = .03). The Mini Mental State Examination (MMSE) was not significantly different between the groups. NHL survivors performed worse than controls in executive functioning (Trail Making Test B-A 47.9 vs 32.1 p = .04, OR for Stroop test time over 75th percentile in survivors: 2.66; CI 95% 1.04-6.61; OR for Multiple Features Target Cancellation time over 75th percentile in survivors: 2.84; CI 95% 1.10-7.31). A small, statistically significant difference was also observed in verbal memory scores between the two groups. .

CONCLUSIONS

The findings of this study suggest that, compared with non-cancer controls, older survivors from NHL may have a lower cognitive performance, especially in the executive functioning and attention domains, regardless of multimorbidity and polypharmacy. Further evidence from larger samples is needed to confirm such findings and better characterize cognitive decline in NHL survivors.

摘要

目的

比较一组老年非霍奇金淋巴瘤(NHL)长期幸存者和同年龄组相应的非癌症对照者的认知功能。还评估了功能状态、多药治疗和多种合并症。

方法

对 63 名年龄在 65 岁及以上的 NHL 门诊长期幸存者和 61 名非癌症对照者进行了一项横断面研究。收集了社会人口统计学、临床和功能数据。通过神经心理测试评估认知功能。

结果

NHL 幸存者的功能状态略差于对照组,他们受更多慢性疾病影响(3.4 对 2.3;p=0.003),服用的药物数量也更多(3.4 对 2.3;p=0.03)。简易精神状态检查(MMSE)在两组间无显著差异。在执行功能方面,NHL 幸存者的表现不如对照组(连线测试 B-A,47.9 对 32.1,p=0.04,幸存者的 Stroop 测试时间超过第 75 百分位数的优势比:2.66;95%CI 1.04-6.61;幸存者的多项特征目标取消时间超过第 75 百分位数的优势比:2.84;95%CI 1.10-7.31)。两组之间在言语记忆评分上也观察到了较小的、有统计学意义的差异。

结论

本研究结果表明,与非癌症对照组相比,老年 NHL 幸存者的认知功能可能较低,尤其是在执行功能和注意力领域,无论是否存在多种合并症和多药治疗。需要更大样本量的进一步证据来证实这些发现,并更好地描述 NHL 幸存者的认知能力下降。

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