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Screening for Delirium and Dementia in the Cancer Patient

Cognitive syndromes are commonly encountered among cancer patients. Although aging is an important risk factor for cognitive disorders, in oncology settings there are additional risk factors, including primary or metastatic brain tumors, medical comorbidities, cancer treatments, and depression, that place all age groups at risk for cognitive syndromes. Delirium, a common cognitive syndrome among hospitalized cancer patients, has been shown to increase risk of long-term cognitive impairment. Dementia is a risk factor for delirium development as well. Patients with cognitive deficits may not be able to carry out activities of daily living, such as medication maintenance, food preparation, and transportation. Treatment adherence, vigilance in monitoring and reporting of cancer and cancer treatment–related symptoms, and the ability to make informed decisions on cancer treatment options necessitate intact cognitive functioning. Therefore, screening for cognitive syndromes among cancer patients is an important part of initial assessment, particularly in high-risk populations. This chapter will provide a comprehensive review of the screening and assessment measures used to identify and assess patients with delirium and dementia. A brief overview of common dementia syndromes is also included as relevant to psycho-oncologists caring for older adults with cancer.