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填补证据空白:通过混合方法和社会倾听研究对老年人轻度认知障碍和血液系统癌症双重挑战的探索性见解

Addressing the evidence gap: exploratory insights into dual challenges of mild cognitive impairment and hematologic cancer in older adults through mixed methods and social listening study.

作者信息

Frisardi Vincenza, De Sando Valeria, Conceining Guia, Schlögl Mathias

机构信息

Geriatric Acute Care, Orthogeriatric Unit and Center for Diagnosis of Cognitive Disorders and Dementia, IRCCS-AOUBO, Albertoni 15, 40138, Bologna, Italy.

Department of Geriatric Medicine, Clinic Barmelweid, Barmelweid, Switzerland.

出版信息

Eur Geriatr Med. 2025 Sep 16. doi: 10.1007/s41999-025-01292-y.

Abstract

PURPOSE

The ageing European population faces a dual burden of increasing mild cognitive impairment (MCI) and hematologic malignancies, yet the overlap of these conditions remains poorly understood and insufficiently addressed in current research and clinical practice. This study aims to explore the unmet needs and challenges encountered by older adults living with both MCI and hematologic malignancies, to inform the development of integrated, person-centered care models for this raising population.

METHODS

A mixed-methods approach was employed, combining a systematic literature review (2018-2023) with qualitative social listening from publicly available caregiver and patient platforms. Screening followed PRISMA guidelines; posts were analyzed thematically using NVivo software.

RESULTS

The systematic review found no eligible studies addressing the dual diagnosis, reflecting a substantial evidence gap. Social listening identified two dominant themes: (1) persistent feelings of isolation among patients and (2) significant emotional and logistical burden on caregivers. Both findings emphasize the disconnect between current care models and patient realities.

CONCLUSION

Older adults with coexisting MCI and hematologic malignancies represent a neglected and highly vulnerable population. The lack of dedicated research and integrated care highlights an urgent need for new clinical frameworks and tools that better account for cognitive health in geriatric oncology. Future research should focus on developing and validating brief, sensitive cognitive screening tools, training clinicians in cognitively-informed oncology care, and designing multidisciplinary support systems for patients and caregivers navigating dual diagnoses.

摘要

目的

老龄化的欧洲人口面临着轻度认知障碍(MCI)增加和血液系统恶性肿瘤的双重负担,但目前的研究和临床实践对这些情况的重叠了解甚少,处理也不够充分。本研究旨在探讨同时患有MCI和血液系统恶性肿瘤的老年人所面临的未满足需求和挑战,为针对这一不断增加的人群制定综合的、以患者为中心的护理模式提供信息。

方法

采用混合方法,将系统文献综述(2018 - 2023年)与从公开的护理人员和患者平台进行的定性社会倾听相结合。筛选遵循PRISMA指南;使用NVivo软件对帖子进行主题分析。

结果

系统综述未发现涉及双重诊断的合格研究,这反映出存在重大的证据空白。社会倾听确定了两个主要主题:(1)患者中持续存在的孤独感;(2)护理人员面临的重大情感和后勤负担。这两个发现都强调了当前护理模式与患者实际情况之间的脱节。

结论

同时患有MCI和血液系统恶性肿瘤的老年人是一个被忽视且高度脆弱的人群。缺乏专门研究和综合护理凸显了迫切需要新的临床框架和工具,以便在老年肿瘤学中更好地考虑认知健康。未来的研究应专注于开发和验证简短、敏感的认知筛查工具,培训临床医生进行认知知情的肿瘤护理,并为应对双重诊断的患者和护理人员设计多学科支持系统。

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