Advanced cancer and concomitant dementia: access to specialized palliative care, emergency room, hospital care, and place of death

BACKGROUND Dementia and advanced cancer are complex, life-limiting conditions that benefit from specialized palliative care (SPC) interventions at the end of life. The objective was to study possible differences in care for patients with concomitant advanced cancer and dementia (CA-DEM) or cancer only (CA) regarding access to SPC, acute hospital care, and place of death.
MATERIALS AND METHODS A retrospective observational registry study on health care consumption data from the Stockholm Regional Council involving logistic regression analyses of age, sex, living arrangements, comorbidities, dementia diagnosis, and socio-economic status.
RESULTS Of the 12,667 persons aged ≥65 years who died from advanced cancer between 2015 and 2019, 605 had concomitant dementia. Of these, 76% of patients with CA and 42% of patients with CA-DEM had access to SPC ( p<.0001 there="" were="" more="" admissions="" to="" palliative="" care="" for="" persons="" not="" living="" in="" nursing="" homes="" p="" women="" socioeconomically="" privileged="" patients="" those="" with="" fewer="" comorbidities="" and="" younger="" access="" spc="" reduced="" er="" visits="" hospitalizations="" acute="" hospital="" deaths="" ca="" whereas="" only="" the="" ca-dem="" group.=""> CONCLUSIONS The probability of being admitted to SPC was lower in cancer patients with known dementia. Access to SPC reduced emergency room visits and acute admissions to hospitals for the whole group, and hospital deaths both for CA and CA-DEM.

as reported in: Acta Oncol. 2022 Apr 12 1-7 [Epub ahead of print]