Cancer Treatment Decision Making in Older Adults with Mild Cognitive Impairment

Many patients with mild cognitive impairment (MCI) will not progress to dementia, and will live years with good quality of life, making cancer one of the greatest risks to their health and wellbeing. Yet, whether patients with MCI receive suboptimal cancer treatment remains unknown. We will compare the receipt of effective cancer treatments among older adults with MCI and cognitively normal adults, and explore how physician recommendations for cancer treatment and caregiver involvement influence the receipt of effective treatments in the context of MCI. We will utilize the Health and Retirement Survey linked with Medicare claims and pilot a physician survey to ascertain whether physician recommendations for cancer treatments differ by the patient’s cognitive status. This study will provide the preliminary data necessary to support an R01 to investigate how physician recommendations, caregiver support and patient preferences influence the receipt of effective cancer treatments among patients with cognitive impairment.