Comorbid Dementia and Cancer in Residents of Nursing Homes: Secondary Analyses of a Cross-Sectional Study.
Kjersti Marie Blytt, Geir Selbæk, Jorunn Drageset and 2 others
PMID 28146014WHAT IT FOUND
Nursing home residents with dementia and cancer had more agitation, apathy and sleep disturbance than residents with cancer alone, yet pain was not measured.
Do not treat these behaviours as only dementia symptoms without a validated pain assessment.
Key findings
01In the analysed sample of 1825 residents, 133 had cancer and 100 had comorbid dementia and cancer.
02Compared with residents with cancer only, residents with comorbid dementia and cancer had more agitation, apathy and sleep disturbance, and worse physical function, but no difference in medication use.
03Compared with residents with dementia only, residents with comorbid dementia and cancer received more analgesics, especially opioids, and had no difference in behavioural symptoms, but the study did not measure pain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study did not use a validated pain assessment, so it cannot show pain intensity or whether analgesics worked. Many eligible residents were not analysed, and the authors could not test whether they differed from those included. The four comparison groups were very different in size, which limits confidence in group comparisons. Dementia was not confirmed by diagnosis; it was rated with the Clinical Dementia Rating scale. Cancer stage, active cancer treatment and whether diagnoses were current or historical were not known. Because residents were interviewed through a primary caregiver proxy, patient self-report was not available. The conclusion section states cancer was more common among residents with dementia, while the results section states the opposite.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the higher analgesic use and more agitation or sleep disturbance as proof that these residents are in pain or that treatment is inadequate. The study did not measure pain, and some symptom differences may reflect dementia rather than cancer.