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

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.