Loneliness and cognitive dysfunction in elderly cancer patients

Abstract

Background: The number of geriatric cancer patients is progressively increasing. The evaluation of cognitive functions is important. Loneliness is an emotional experience that results from unmet personal or social requirements. The association between loneliness and cognitive dysfunction has been well documented in elderly patients. However, there is no data in elderly cancer patients. The purpose of this study is to evaluate the association between loneliness and cognitive dysfunction in geriatric cancer patients. Methods: Patients, more than 65 years of age, in departments of medical oncology and geriatrics were included. Patients were evaluated with structured questionnaires to define sociodemographic and clinical characteristics. In addition, patients were tested with multidimensional Scale of Perceived Social Support (PSC), UCLA loneliness Scale (ULS), standardized mini mental state examination (SMMSE), Clock drawing test and geriatric depression scale (GDS). Results: 314 elderly patients (214 with a diagnosis of cancer and 120 without cancer) were evaluated. Scores of PSC, ULS, SMMSE were higher in patients without cancer. Median score of GDS in cancer patients was higher than non-cancer patients (4 vs 2, p<0.001). The analysis of ULS and SMMSE showed a negative correlation between loneliness and cognitive functions (r=-0.185, p=<0.001). The negative correlation was observed both in cancer patients (r=-0.206, p=0.001) and non-cancer patients (r= -0.262, p=0.002). In multivariate analysis; presence of depression, low PSC scores and low educational status were associated with high ULS scores. In the multivariate analysis of factors associated with cognitive dysfunction concluded that depression was associated with increased risk of cognitive dysfunction. (RR: 2.64 (1.3-5.1), 95% CI), p=0.004) (Table). Conclusions: In elderly cancer patients, cognitive functions are negatively effected by increased loneliness. However, the association between cancer diagnosis, loneliness and cognitive dysfunction couldn't be demonstrated in multivariate analysis. (Table Presented).