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

SIMPLE SUMMARY: Receiving a diagnosis of cancer in older adults supersizes the coexisting multimorbidity and frailty of the single individual. The multidimensional nature of this diagnosis needs to be appropriately targeted in the realm of the entire spectrum of cancer care, including the survivorship phase and the continuum of supportive care. The identification of late-life symptoms, syndromes, and the trajectory of frailty throughout the cancer course hold promise to better capture the clinical complexity of old-age patients and deliver targeted new pathways of care. In particular, neuropsychiatric disorders, beyond dementia, given their intrinsic association with frailty, need to be further explored to understand their impact on cancer disease course. Starting from this background, we aimed to assess the presence of neuropsychiatric conditions, including depression, sleep disturbances, anxiety, behavioral disturbances, attitude, motivation, and support in older adults receiving a diagnosis of cancer in order to understand the magnitude of the problem that may serve as a platform for future multidisciplinary studies and target interventions. 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.