Faculty Bibliography

Delirium is frequently encountered when caring for cancer patients, from initial diagnosis to the advanced stages of the disease; however, it is often missed. Oncologists need to be familiar with the various defining features of the condition, and should be able to identify common underlying causes. We present a systematic approach to the workup, as well as pharmacologic and nonpharmacologic approaches to management. We discuss the common practice of treatment with neuroleptics, as well as recent controversy surrounding their use.

PURPOSE OF REVIEW:Cancer, aging, and cognition form a complicated interface that can challenge patients, caretakers, and healthcare professionals. Although the typical aging process allows for compensatory mechanisms to help maintain daily functioning, cancer and cancer treatments can remove the fail-safes and exacerbate cognitive decline. As a result, older cancer patients can experience increased morbidity and mortality. The goal of this article is to provide additional assessment strategies, diagnostic considerations, and treatment options for providers taking care of this growing population. RECENT FINDINGS:In this review, we will discuss current areas of research with regard to epidemiology and our current understanding of cancer-related cognitive impairment in the older patient, while reinforcing the importance of the Comprehensive Geriatric Assessment in assessment, prognosis, and treatment guidance. SUMMARY:Although cognitive impairment in the older cancer patient may be an increasing cause of concern with several gaps in research, there are opportunities to take a methodical treatment approach.