Claire Robb

Patterns of Care and Survival in Cancer Patients with Cognitive Impairment

To address the emerging concern of oncologists who can expect to see an increasing number of older cancer patients with dementia, this retrospective case-control study compared a sample of older cancer patients with cognitive impairment (N=86) to a non-cognitively impaired control group (N=172) as to patterns of care and survival by age, site and stage. Treatment patterns presented much less differences between both groups than in other series. After adjusting for age, sex, performance status, ADLs/IADLs and comorbidity, results showed significantly greater survival (values p<.001) in the non-impaired control group (Mdn=72.6 months) compared to the cognitively impaired cases (Mdn=23.0 months). Similar results were found when we compared these groups according to tumor stage and cancer site (breast versus other). Across tumor types and stages, cognitively impaired patients have approximately one-third the median survival of the control group. This survival can still be a significant number of years.

Gender differences in coping with functional disability in older married couples: the role of personality and social resources.

The present study examines the impact of functional disability on subjective well-being (SWB) and the moderating effects of personal resources on a sample of 144 community-dwelling, older adult couples age 60–84 years, with emphasis on gender differences in both direct and moderating effects. Functional disability in self and in the spouse was associated with poorer well-being in both men and women, but differences were found by gender in the effects of coping resources. While high neuroticism was associated with poorer well-being for both husbands and wives, extraversion and social support had unique benefits in enhancing well-being only in husbands. Husbands were more introverted, and had fewer social resources, and individual differences in social resources may be more critical for older husbands. Results are interpreted in terms of gender differences in coping and their implications for interventions to enhance well-being in older adults.