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