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Am Fam Physician. 1998;57(10):2503

The diagnosis of cancer can cause a significant physical burden for patients. Such a diagnosis may have an even greater impact on elderly patients. At the present time, the question of whether a diagnosis of cancer decreases the functional status of elderly patients is a matter of controversy. Stafford and Cyr assessed the specific impact that a diagnosis of cancer may have on elderly patients and what parameters may be used to identify high-risk groups.

A stratified random sample of 9,745 Medicare benificiaries were evaluated. The study subjects underwent a personal interview that included questions about demographics, medical conditions, current health status, issues related to health care access, satisfaction with medical care and an evaluation of the patient's ability to perform activities of daily living (ADL) and independent activities of daily living (IADL).

Results of the study indicated that the self-reported health status of patients with cancer was worse than that of patients without a chronic condition. The diagnosis of lung cancer produced the worst results in self-reported health status. Patients with cancer reported more limitations in ADL and IADL capabilities than those without cancer. Health care utilization was higher in the cancer group as well. Cancer patients with lower socioeconomic status were more likely to report poor health status, functional limitations, increased health care costs and dissatisfaction with their health care.

The authors conclude that when the diagnosis of cancer is established in elderly patients, physicians must be aware of the difficulties facing these patients. Physicians should establish a care plan that addresses the treatment of the cancer as well as interventions to reduce the impact on elderly patients' functional status.

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Copyright © 1998 by the American Academy of Family Physicians.

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