Impact of cognitive impairment on end-of-life care in patients with respiratory cancers

Respir Investig. 2025 Jan;63(1):10-12. doi: 10.1016/j.resinv.2024.11.012. Epub 2024 Nov 28.

Abstract

Backgrounds: With the aging population of Japan, an increase in patients with respiratory cancers coexisting with dementia is anticipated; however, the characteristics and terminal courses of these patients remain unclear.

Methods: We retrospectively assessed 142 patients with respiratory cancers receiving home health care, grouping them based on the presence of cognitive impairment and comparing their backgrounds.

Results: Cognitive impairment was confirmed in 38 patients (26.8%), and these individuals were older and had a higher incidence of brain metastases than those without cognitive impairment. There was no statistically significant difference in 3-month survival rates. Patients with cognitive impairment exhibited significantly lower opioid use (23.5 vs. 76.4 mg/day, p < 0.001) and lower utilization of patient-controlled analgesia (43.3% vs. 67.4%, p = 0.029).

Discussion: Our data reflect either milder symptoms or difficulty in accurately expressing pain or discomfort among patients with cognitive impairment, underscoring the importance of careful observation and management.

Keywords: Cognitive impairment; Dementia; Lung cancer; Malignant mesothelioma.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Analgesics, Opioid / administration & dosage
  • Brain Neoplasms / complications
  • Brain Neoplasms / secondary
  • Cognitive Dysfunction* / etiology
  • Female
  • Home Care Services
  • Humans
  • Japan / epidemiology
  • Lung Neoplasms / complications
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate
  • Terminal Care*

Substances

  • Analgesics, Opioid