A Twin Study of Cognitive Outcomes in Older Adult Cancer

老年人癌症认知结果的双胞胎研究

• 批准号: 7128101
• 负责人: Margaret Gatz
• 金额: $ 6.32万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7128101
• 关键词: cancer registry /resource; chemotherapy; clinical research; cognition disorders; comorbidity; dementia; disease /disorder proneness /risk; human data; human old age (65+); human therapy evaluation; interdisciplinary collaboration; long term survivor; longitudinal human study; mental disorder diagnosis; neoplasm /cancer diagnosis; prognosis; radiation therapy; therapy adverse effect; twin /multiplet

DESCRIPTION (provided by applicant): This project addresses the longer term cognitive impact of cancer and its treatment on older adults through use of the population-based Swedish Twin Registry. All twins aged 65+ who have survived any malignant cancer [excluding brain cancer] for three or more years have been identified through the nationwide Swedish Cancer Registry. From a previous NIA-funded study, we have collected data about cognitive outcomes for these twins, including telephone screening for cognitive impairment and diagnoses for dementia based on complete clinical evaluations. For the proposed project, we will link information about cancer with information about cognitive function. Funding will permit analyzing these previously collected data for epidemiologic purposes and for planning a future larger application. The Cancer Registry indicates the cancer diagnosis and the center where treatment took place for all patients. The registry does not indicate type of treatment. Thus, we propose to go to the cancer treatment centers and obtain records for each survivor. From the records, we will abstract detailed information about date, type, length, and dose of treatment. This is the main activity that cannot take place without funding. This information will be used to test the hypothesis that cancer survivors will have poorer cognitive functioning and will be more likely to be clinically diagnosed as demented than older adults who have not been treated for cancer, controlling for measured covariates (education, alcohol use, and physical exercise) and hypothesized mediators (cardiovascular disease, depressive symptoms, and fatigue), as well as unmeasured familial effects (genetic influences and shared environmental influences early in life). Secondly, we will examine how specific treatments, for example, chemotherapy and radiotherapy, relate to impairment. Hypotheses will be tested comparing those who have been diagnosed with cancer to both (1) co-twins, that is, within each pair, the twin sibling who has not been diagnosed with cancer, and (2) an unrelated comparison group consisting of individual twins who were not diagnosed with cancer and are not related to the individuals with cancer. The co-twin study includes over 500 twin pairs discordant for cancer, with average survival of nearly 12 years since diagnosis. For the unrelated comparison design, we will match three individuals from the twin registry to each of over 700 cancer survivors. Data on key outcomes and relevant covariates will come from the Inpatient Discharge Registry; questionnaires collected when the twin registry was formed over 30 years ago; a telephone interview of the entire twin registry in 1998-2001; and clinical evaluations for dementia conducted after telephone screening. This study capitalizes on a uniquely available population-based dataset of older adult cancer survivors. Through abstracting data from cancer treatment records and linking them to existing datasets, we will be able to examine possible longer term effects, along with likely covariates, with optimal comparison groups.

描述(由申请人提供)： 该项目通过使用以人口为基础的瑞典双胞胎登记处，解决癌症及其治疗对老年人的长期认知影响。所有65岁以上的双胞胎，在任何恶性肿瘤(不包括脑癌)存活三年或更长时间后，都已通过瑞典全国癌症登记中心进行了鉴定。从之前NIA资助的一项研究中，我们收集了关于这些双胞胎的认知结果的数据，包括基于完整的临床评估的电话认知障碍筛查和痴呆症诊断。在拟议的项目中，我们将把关于癌症的信息与关于认知功能的信息联系起来。资金将允许出于流行病学目的分析这些以前收集的数据，并规划未来的更大规模的应用。 癌症登记处注明了所有患者的癌症诊断和治疗中心。登记处没有说明治疗的类型。因此，我们建议去癌症治疗中心，为每一位幸存者获取记录。我们将从记录中提取有关治疗日期、类型、持续时间和剂量的详细信息。这是没有资金就不能进行的主要活动。 这些信息将被用来检验这一假设，即癌症幸存者的认知功能将比没有接受癌症治疗的老年人更差，临床上更有可能被诊断为痴呆症，控制测量的协变量(教育、饮酒和体育锻炼)和假设的中介因素(心血管疾病、抑郁症状和疲劳)，以及未测量的家庭影响(遗传影响和共同的早期环境影响)。其次，我们将研究具体的治疗方法，如化疗和放射治疗，与损伤之间的关系。 将测试假设，将已被诊断为癌症的人与(1)同卵双胞胎，即每对中未被诊断为癌症的双胞胎兄弟姐妹进行比较，以及(2)由未被诊断为癌症且与癌症患者没有血缘关系的单独双胞胎组成的不相关的对照组。这项同卵双胞胎研究包括500多对与癌症不一致的双胞胎，自确诊以来平均存活近12年。对于不相关的比较设计，我们将双胞胎登记中的三个人与700多名癌症幸存者中的每个人进行匹配。 有关主要结果和相关协变量的数据将来自住院患者出院登记处；30多年前双胞胎登记处成立时收集的问卷；1998-2001年对整个双胞胎登记处的电话访问；以及电话筛查后对痴呆症的临床评估。 这项研究利用了一个独特的基于人群的老年癌症幸存者数据集。通过从癌症治疗记录中提取数据并将它们链接到现有数据集，我们将能够通过最佳比较组来检查可能的长期影响，以及可能的协变量。