@article{679d659db14f46fc8c31c72ea2808ab9,
title = "Evaluation of mild cognitive impairment and dementia in patients with metastatic renal cell carcinoma",
abstract = "Background: Dementia and cancer are both more common in adults as they age. As new cancer treatments become more popular, it is important to consider how these treatments might affect older patients. This study evaluates metastatic renal cell carcinoma (mRCC) as a risk factor for older adults developing mild cognitive impairment or dementia (MCI/D) and the impact of mRCC-directed therapies on the development of MCI/D. Methods: We identified patients diagnosed with mRCC in a Surveillance, Epidemiology, and End Results (SEER)-Medicare dataset from 2007 to 2015 and matched them to non-cancer controls. Exclusion criteria included age < 65 years at mRCC diagnosis and diagnosis of MCI/D within the year preceding mRCC diagnosis. The main outcome was time to incident MCI/D within one year of mRCC diagnosis for cases or cohort entry for non-cancer controls. Cox proportional hazards models were used to measure associations between mRCC and incident MCI/D as well as associations of oral anticancer agent (OAA) use with MCI/D development within the mRCC group. Results: Patients with mRCC (n = 2533) were matched to non-cancer controls (n = 7027). mRCC (hazard ratio [HR] 8.52, p < .001), being older (HR 1.05 per 1-year age increase, p < .001), and identifying as Black (HR 1.92, p = .047) were predictive of developing MCI/D. In addition, neither those initiating treatment with OAAs nor those who underwent nephrectomy were more likely to develop MCI/D. Conclusions: Patients with mRCC were more likely to develop MCI/D than those without mRCC. The medical and surgical therapies evaluated were not associated with increased incidence of MCI/D. The increased incidence of MCI/D in older adults with mRCC may be the result of the pathology itself or risk factors common to the two disease processes.",
keywords = "Antineoplastic agents, Cognitive dysfunction, Dementia, Nephrectomy, Renal cell carcinoma",
author = "Miller, {Samuel M.} and Wilson, {Lauren E.} and Greiner, {Melissa A.} and Pritchard, {Jessica E.} and Tian Zhang and Kaye, {Deborah R.} and Cohen, {Harvey Jay} and Becher, {Robert D.} and Maerz, {Linda L.} and Dinan, {Michaela A.}",
note = "Funding Information: Research reported in this manuscript was supported by the National Cancer Institute of the National Institutes of Health under award number 3R01CA226842-02S1 . This grant is funding upwards of 95% of the costs associated with this project for a total of $320,400. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute {\textquoteleft}s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California , contract HHSN261201000035C awarded to the University of Southern California , and contract HHSN261201000034C awarded to the Public Health Institute ; and the Centers for Disease Control and Prevention {\textquoteleft}s National Program of Cancer Registries, under agreement # U58DP003862-01 awarded to the California Department of Public Health . The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred. The authors acknowledge the efforts of the National Cancer Institute; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.” Funding Information: Research reported in this manuscript was supported by the National Cancer Institute of the National Institutes of Health under award number 3R01CA226842-02S1. This grant is funding upwards of 95% of the costs associated with this project for a total of $320,400. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.The collection of cancer incidence data used in this study was supported by the California Department of Public Health as part of the statewide cancer reporting program mandated by California Health and Safety Code Section 103885; the National Cancer Institute{\textquoteleft}s Surveillance, Epidemiology and End Results Program under contract HHSN261201000140C awarded to the Cancer Prevention Institute of California, contract HHSN261201000035C awarded to the University of Southern California, and contract HHSN261201000034C awarded to the Public Health Institute; and the Centers for Disease Control and Prevention{\textquoteleft}s National Program of Cancer Registries, under agreement # U58DP003862-01 awarded to the California Department of Public Health. The ideas and opinions expressed herein are those of the author(s) and endorsement by the State of California Department of Public Health, the National Cancer Institute, and the Centers for Disease Control and Prevention or their Contractors and Subcontractors is not intended nor should be inferred. The authors acknowledge the efforts of the National Cancer Institute; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database.”Dr. Miller's time is funded by the Yale National Clinician Scholars Program and by Clinical and Translational Science Award number TL1 TR001864 from the National Center for Advancing Translational Science. Funding Information: Dr. Miller's time is funded by the Yale National Clinician Scholars Program and by Clinical and Translational Science Award number TL1 TR001864 from the National Center for Advancing Translational Science . Publisher Copyright: {\textcopyright} 2021 Elsevier Inc.",
year = "2022",
doi = "10.1016/j.jgo.2021.12.012",
language = "English (US)",
journal = "Journal of Geriatric Oncology",
issn = "1879-4068",
publisher = "Elsevier Limited",
}