化疗对老年肿瘤患者认知功能的影响

Assessment of the cognitive impairment in elderly cancer patients treated with chemotherapy

目的探讨化疗对65岁以上的老年肿瘤患者认知功能的影响。方法选择2009年8月至2010年12月我院65岁以上进行化疗的老年肿瘤患者,采用筛查轻度认知功能损害的蒙特利尔认知评估量表(MoCA量表北京版)对8个认知领域(包括注意与集中、执行功能、记忆、语言、视结构技能、抽象思维、计算和定向力)进行评估,分别于化疗前和3周期化疗结束后1个月进行测定。结果 130例老年肿瘤患者入组,中位年龄71岁(65～86岁)。全体患者化疗前MoCA量表评分为25.9±3.6,化疗后为26.3±3.0,无显著性差异。化疗前存在轻度认知功能损害者占24.6%,化疗后占22.3%。结论老年肿瘤患者中存在一定比例的轻度认知功能损害,化疗在短期内对老年患者认知功能的影响较小。受教育程度和血管危险因素是影响MoCA评分的主要因素。

Objective To investigate the cognitive impairment in elderly cancer patients treated with chemotherapy. Methods 130 elderly patients received cognitive assessment by the Chinese Beijing version of Montreal Cognitive Assessment Scale （MoCA） before chemotherapy, and the cognitive assessment was performed again after 3 cycles of chemotherapy. Results There was not significant changes in the scores of MoCA after 3 cycles of chemotherapy （25.9±3.6 vs. 26.3±3.0, P 〉 0.05） compared with those before chemotherapy. The rate of mild cognitive impairment before and after 3 cycles chemotherapy was 24.6% and 22.3% ,respectively. Conclusions Elderly patients have elevated rate of mild cognitive impairment. However, our results do not support that chemotherapy is associated with cognitive impairment in Chinese elderly patients. Educational level and vascular risk factors may affect the MoCA scores.