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Review
. 2022 Jan 5;14(1):258.
doi: 10.3390/cancers14010258.

Neuropsychiatric Disorders and Frailty in Older Adults over the Spectrum of Cancer: A Narrative Review

Mariya Muzyka  1   2 , Luca Tagliafico  1   2 , Gianluca Serafini  1   3 , Ilaria Baiardini  1 , Fulvio Braido  1   2 , Alessio Nencioni  1   2 , Fiammetta Monacelli  1   2
Affiliations
Review

Neuropsychiatric Disorders and Frailty in Older Adults over the Spectrum of Cancer: A Narrative Review

Mariya Muzyka et al. Cancers (Basel). .

Abstract

Background: The interplay between different neuropsychiatric conditions, beyond dementia, in the presence of a diagnosis of cancer in older adults may mediate patients' fitness and cancer-related outcomes. Here, we aimed to investigate the presence of depression, sleep disturbances, anxiety, attitude, motivation, and support in older adults receiving a diagnosis of cancer and the dimension of frailty in order to understand the magnitude of the problem.

Methods: This review provides an update of the state of the art based on references from searches of PubMed between 2000 and June 2021.

Results: The evidence obtained underscored the tight association between frailty and unfavorable clinical outcomes in older adults with cancer. Given the intrinsic correlation of neuropsychiatric disorders with frailty in the realm of cancer survivorship, the evidence showed they might have a correlation with unfavorable clinical outcomes, late-life geriatric syndromes and higher degree of frailty.

Conclusions: The identification of common vulnerabilities among neuropsychiatric disorders, frailty, and cancer may hold promise to unmask similar shared pathways, potentially intercepting targeted new interventions over the spectrum of cancer with the delivery of better pathways of care for older adults with cancer.

Keywords: anxiety; attitude; cancer; depression; frailty; motivation; neuropsychiatry; older adults; sleep disturbances; support.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart diagram of studies selection process according to the inclusion criteria.
Figure 2
Figure 2
Bidirectional interplay among biological aging, the moderating role of inflammaging and immunosenescence, and frailty biomarkers on the basis of the conceptual frailty framework of the physical frailty phenotype of Fried (FP) or the deficit accumulation model of Rockwood (FI). Interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and white blood cells (WBCs), T follicular helper cell (Tfh cell) subsets, interleukin-1 receptor antagonist (IL-1Ra), soluble endothelial leukocyte adhesion molecule-1 (sE-selectin), C-X-C motif chemokine ligand 10 (CXCL10), transforming growth factoR-β (TGF-β), dehydroepiandrosterone (DHEA), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein1–3 (IGFBP 1–3), and glomerular filtration rate (GFR).
Figure 3
Figure 3
Multidirectional interplay between cancer, frailty, and neuropsychiatric disorders in older adults with cancer and putative progression of frailty and late-life symptoms along with potential frailty reversibility targeted interventions. REM: rapid eye movement.
See this image and copyright information in PMC

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