Evaluation of cognition in cancer patients: special focus on the elderly.
PURPOSE: The risks of both cognitive dysfunction and most cancers increase with age. A literature review was undertaken to identify how cognitive issues in older patients were being assessed in the oncology literature. METHODS: A systematic literature search was undertaken using a number of different search terms and databases to find all relevant articles in oncology and internal medicine journals. RESULTS: Eighty-eight articles were included in the review. Just over half of the articles studied a mixture of cancer types and had fewer than 100 patients. The vast majority of patients being studied were <65 years of age. While a little over half of the articles used >or=3 neuropsychological tests to assess cognition, more than 60 different tests were used to assess cognition. Forty-one percent of the studies were prospective trials, with most of the rest divided between cross-sectional and observational. One-fifth of the articles involved patients at end-of-life. CONCLUSION: The oncology literature contains little information about cognition in older cancer patients. More systematic and comprehensive studies of this important aspect of cancer care in the elderly are necessary.