Prognostic impact of neurocognitive disorders in older patients with cancer: the ELCAPA prospective cohort study

Area of Science:

• Geriatric Oncology
• Neuroscience
• Clinical Epidemiology

Background:

• Older adults with cancer often present with neurocognitive disorders (NCD).
• The prognostic impact of NCD on mortality in this population requires further clarification.

Purpose of the Study:

• To evaluate the prognostic value of neurocognitive disorder (NCD) for 12-month overall mortality in patients aged 70 years and older diagnosed with solid cancer.

Main Methods:

• A prospective, observational, multicenter cohort study (ELCAPA) was conducted.
• Neurocognitive disorder was classified into four categories (none, mild, moderate, major) based on MMSE, memory complaints, and IADL scores.
• Multivariable survival analysis assessed the association between NCD classes and 12-month mortality, adjusting for clinical and treatment variables.

Main Results:

• 2784 patients (median age 82) with solid cancer were analyzed; 13% had major NCD.
• Major NCD was an independent predictor of 12-month mortality (aHR 1.54; 95% CI 1.19-1.98).
• Other mortality predictors included cancer type, metastatic status, poor general health, and palliative care.

Conclusions:

• Major neurocognitive disorder possesses direct prognostic value for 12-month mortality in older patients with solid cancer.
• This prognostic value is independent of geriatric factors, cancer type, and treatment strategy.
• NCD assessment should be integrated into the prognostic evaluation of elderly cancer patients.