Effective clinical cancer treatment, care and management for people with comorbid cancer and dementia: understanding population demographics and intervention priorities and outcomes (CanDem-Int)


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Michelle Collinson1,Ellen Mason1,Laura Ashley2,Amanda Farrin1,Alys Griffiths3,June Hennell4,Rachael Kelley3,Claire Surr3
1Clinical Trials Research Unit, University of Leeds, Leeds, UK,2School of Social Sciences, Leeds Beckett University, Leeds, UK,3Centre for Dementia Research, Leeds Beckett University, Leeds, UK,4Centre for Dementia Research Expert by Experience group, Leeds Beckett University, Leeds, UK

Abstract

Background

Dementia and cancer are both common among older people, making it likely that many people will have both conditions. People living with dementia and cancer could have complex care needs, making cancer care provision more difficult. However, there is little research in this area to inform practice.

Method

We undertook two studies. Study 1 analysed a large dataset from UK GP records. We identified the numbers of people with cancer and dementia, their characteristics, and their NHS service use. Study 2 used ethnographic methods to explore experiences of cancer care for people living with dementia. We used interviews, conversations and observations of cancer care to include the perspectives of people living with cancer and dementia, their families, and hospital staff.

Results

Study 1 examined the GP records of 166,000 people living with cancer and/or dementia; 7.5% of people with cancer aged ≥75 also had dementia, and similarly 7.5% of people aged ≥75 with dementia also had cancer. Dementia rates amongst people with the ten most common cancers ranged from 1.2% (brain, other CNS and intracranial tumours) to 5% (bladder cancer). People with both conditions attended 1.5 primary care appointments on average per month, compared to 1.1 for those with dementia alone and 1.4 for those with cancer alone. Study 2 identified a number of cancer care challenges for people living with dementia, including recognition of dementia and difficulties around decision-making, care processes and care environments. Families played important and difficult to replicate roles in their relative’s care.

Conclusion

This study provides the best available UK estimates of the size, characteristics and cancer care needs of people living with dementia. It highlights areas where hospitals and staff may be able to improve cancer treatment and care experiences for people living with dementia, and areas for further research.

Acknowledgement: A version of this abstract has been published previously for the 29th Alzheimer Europe Conference “Making valuable connections”, see https://www.alzheimer-europe.org/Conferences/The-Hague-2019/Detailed-programme-and-abstracts/P22.-Acute-and-hospital-care for original and CC-BY license.