title: Health status in older hospitalized patients with cancer or non-neoplastic chronic diseases.
abstract: BACKGROUND
  Whether cancer is more disabling than other highly prevalent chronic diseases in the elderly is not well understood, and represents the objective of the present study.
  
  
  METHODS
  We used data from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA) study, a large collaborative observational study based in community and university hospitals located throughout Italy. Our series consisted of three groups of patients with non-neoplastic chronic disease (congestive heart failure, CHF, N = 832; diabetes mellitus, N = 939; chronic obstructive pulmonary disease, COPD, N = 399), and three groups of patients with cancer (solid tumors without metastasis, N = 813; solid tumors with metastasis, N = 259; leukemia/lymphoma, N = 326). Functional capabilities were ascertained using the activities of daily living (ADL) scale, and categorical variables for dependency in at least 1 ADL or dependency in 3 or more ADLs were considered in the analysis. Cognitive status was evaluated by the 10-items Hodgkinson Abbreviated Mental Test (AMT).
  
  
  RESULTS
  Cognitive impairment was more prevalent in patients with CHF (28.0%) or COPD (25.8%) than in those with cancer (solid tumors = 22.9%; leukemia/lymphoma = 19.6%; metastatic cancer = 22.8%). Dependency in at least 1 ADL was highly prevalent in patients with metastatic cancer (31.3% vs. 24% for patients with CHF and 22.4% for those with non-metastatic solid tumors, p < 0.001). In people aged 80 years or more, metastatic cancer was not associated with increased prevalence of physical disability. In multivariable analysis, metastatic cancer was associated with a greater prevalence of physical (OR 2.09, 95%CI 1.51-2.90) but not cognitive impairment (OR 1.34, 95%CI 0.94-1.91) with respect to CHF patients. Finally, diabetes was significantly associated with cognitive impairment (OR 1.40, 95%CI 1.11-1.78).
  
  
  CONCLUSIONS
  Cancer should not be considered as an ineluctable cause of severe cognitive and physical impairment, at least not more than other chronic conditions highly prevalent in older people, such as CHF and diabetes mellitus.
authors.affiliation: Istituto Nazionale di Ricovero e Cura per Anziani, Cosenza, Italy. andrea_corsonello@tin.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Corsonello
authors.forename: Claudio
authors.initials: C
authors.lastname: Pedone
authors.forename: Luciana
authors.initials: L
authors.lastname: Carosella
authors.forename: Francesco
authors.initials: F
authors.lastname: Corica
authors.forename: Bruno
authors.initials: B
authors.lastname: Mazzei
authors.forename: Raffaele Antonelli
authors.initials: RA
authors.lastname: Incalzi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D048909:Diabetes Complications / Q000150:complications*; D005260:Female; D006304:Health Status; D006333:Heart Failure / Q000150:complications*; D006760:Hospitalization; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications*