Age-related Differences in Recall of Information and Handling of Chemotherapy-related Side Effects in Cancer Patients: The ReCap Study

Abstract

Background To prevent severe toxicity and hospital admissions, adequate management and recall of information about side effects are crucial and health literacy plays an important role. If age-related factors impact recall of given information and handling of side effects, revised ways to give information are required. Patients and Methods We undertook a questionnaire-based survey among 188 newly diagnosed patients with pancreatic cancer or colorectal cancer and chemo-naive patients with prostate cancer treated with adjuvant or first-line palliative chemotherapy comprising satisfaction with given information, recall of potential side effects, and handling of hypothetical side effect scenarios. We evaluated the association between baseline characteristics, ie, age, frailty (G8 score), comorbidity (Charlson Comorbidity Index), cognitive function (Mini-Cog), satisfaction, recall of information, and handling of side effects. Results Reduced ability to recall information about several side effects (eg, chest pain) was associated with older age (odds ratio adjusted for cancer [aOR] 0.94 [95% CI, 0.88-0.98]) and poor cognitive screening (aOR 0.56 [95% CI, 0.33-0.91]). Insufficient or dangerous handling of side effects was associated with older age (aOR 0.96 (95% CI, 0.92-0.99)) and cognitive impairment (aOR 0.70 [95% CI, 0.50-0.95]). Conclusion Older age and poor cognitive screening may impact patients’ ability to understand and adequately handle chemotherapy-related side effects. Cognitive screening and focus on individual ways to give information including assessment of recall and handling are needed.

A Systematic Review Focusing on Understanding the Effects of a Defined Set of Non-Modifiable Factors in Patients who Suffer from Chemotherapy Induced Cognitive Impairments or “Chemobrain”

“…For demographics, the primary theme observed age as the largest predictive factors for the development of this condition although not the only predictive factor. [4][5][6] However, there is an association of worse quality of life due to CICI symptoms in patients who are younger. Younger patients usually do not have cognitive impairment, but perceived changes have greater impact on their quality of life when there is development of CICI.…”

“…The studies in this demographic section involve exploring patient age as a factor for predicting CICI.Lund et al used the Mini-Cog assessment to see if sociodemographic information had any effect on the CICI complaints of 188 newly diagnosed pancreatic, colorectal, and prostate cancer patients. They concluded that patients of older age (aOR 0.94 [95% CI, 0.88-0.98]) had higher risk of developing CICI (aOR 0.56 [95% CI, 0.33-0.91]) 4. Dos Santos et al used the Mini-Mental State Examination (MMSE) assessment in older cancer patients (≥ 70 yrs) and concluded they were also at higher risk of CICI complaints through predictive factors (OR = 2.58, p = 0.022).…”

Additional Value of Mini-Cog© in Urogeriatric Patients Concurrently Screened by G8 Scores

“…To the knowledge of the authors, there are no published data of patients available in the literature evaluating the combination of both tests in urogeriatric patients. Our Medline research only revealed a few studies in non-urologic patients in which both tests were applied [16][17][18]. Among them is a recent Irish pilot study in which both tests were performed in metastatic cancer patients, but the additional value for the Mini-Cog© was not evaluated [18].…”