Literature Review

US dementia cases projected to double within 40 years Medscape Medical News; by Pauline Anderson; 1/13/25 The number of US adults who will develop dementia each year is projected to increase from approximately 514,000 in 2020 to about 1 million in 2060, new research shows. In addition, the lifetime risk of developing dementia after age 55 is estimated at 42%. The research showed that the relative growth in dementia cases is particularly pronounced for Black adults. These new findings researchers say, “highlight the urgent need for policies that enhance healthy aging, with a focus on health equity.”

Guidelines for evaluating, diagnosing, and disclosing dementia published by Alzheimer’s Association Practical Neurology; 1/14/25 The Diagnostic Evaluation, Testing, Counseling, and Disclosure Clinical Practice Guideline (DETeCD-ADRD CPG) Workgroup, convened and funded by the Alzheimer’s Association, has developed new recommendations for clinicians to use when evaluating patients with possible Alzheimer disease (AD) or AD and related dementias (ADRD). An executive summary of the recommendations for use in primary care and other practice settings was published in Alzheimer’s & Dementia, along with a companion article summarizing specific guidance for specialists. The Workgroup included representatives from  primary, specialty, subspecialty, long-term, and palliative care disciplines as well as the fields of health economics and bioethics.  Editor's note: Click for open access to the Alzheimer's Association clinical practice guideline ..., executive summary of recommendations for primary care. 

Hospice of the Chesapeake expands inpatient care with high-flow oxygen therapy Southern Maryland News Net; by Hospice of the Chesapeake; 1/13/25 Hospice of the Chesapeake is proud to announce the addition of high-flow oxygen therapy to its inpatient care centers, enhancing the quality of care for patients with complex respiratory needs. ... High-flow oxygen therapy is designed to deliver precise oxygen levels, improving breathing efficiency and overall comfort for patients. ... “Adding high-flow oxygen therapy to our inpatient care centers represents our commitment to providing comprehensive, patient-centered care,” said Dr. Sonja Richmond, Vice President of Medical Affairs & Hospice Medical Director. “This advancement enables us to better meet the needs of our patients and their families during a challenging time.”

A call to action for revisiting goals of care discussions with adolescents and young adults with cancerJAMA Network Open; Erica C. Kaye, MD, MPH; 12/24In “Evolution in Documented Goals of Care at End of Life for Adolescents and Young Adults With Cancer,” Mastropolo et al addresses an important and understudied question regarding whether and how goals of care (GOC) change for adolescents and young adults (AYAs) with cancer as death approaches. Intuitively, the study findings showed that AYAs with cancer had increased documentation of palliative GOC as they approached end of life. More specifically, 1 in 5 AYAs had GOC documentation that transitioned from nonpalliative goals in the early or middle periods to palliative in the final 30 days before death. While perhaps unsurprising, the clinical relevance of this finding is significant: a sizeable minority of AYAs may change their GOC during the final weeks of life, underscoring the importance of revisiting GOC conversations as death approaches to align medical interventions with a patient’s wishes. 

End-of-life care can be more aggressive for cancer patients with defibrillators Medical Xpress; by UT Southwestern Medical Center; 1/8/25 Patients with advanced cancer who also had cardiac defibrillators were more likely than those without these implants to receive aggressive end-of-life care, a team led by UT Southwestern Medical Center researchers found in a new study. The findings, published in Cancer, could help physicians guide patients in this growing population toward care that better matches their goals. ... The findings showed that about 6% of patients with advanced cancer also had [implantable cardioverter defibrillators] ICDs. However, significantly more of the ICD patients received aggressive care during the last month of their lives compared to those without these devices.

Methadone in cancer-related neuropathic pain: A narrative reviewCurrent Oncology; Faten Ragaban, Om Purohit, Egidio Del Fabbro; 12/24The unique mechanisms of action and preliminary clinical trials support methadone's status as the first opioid to consider for CRNP [cancer-related neuropathic pain] when non-opioid first-line treatments have failed to alleviate patient symptoms. Methadone can also be considered as a first-line opioid in patients with mixed nociceptive-neuropathic pain and any of the following features: renal dysfunction; administration of opioids through a feeding tube; a lack of financial resources/insurance; and a switch from another high-dose opioid. More research is needed regarding methadone for CRNP and methadone's preferential use in specific sub-groups of patients.

Nutrition in advanced disease and end of life cancer careSeminars in Oncology Nursing; Betty Ferrell, Nathaniel Co, William E. Rosa; 12/24Throughout the cancer continuum—starting at diagnosis and throughout disease-directed treatment, end-of-life care, and survivorship—nutrition screening, counseling, and intervention should be routinely considered integral to care. During cancer treatment, these nutritional components serve as adjuvants to therapy with significant benefits to body composition, quality of life, and survival with improved nutrition. The phases of advanced disease and also end of life care present unique challenges related to nutrition which is the focus of this paper. Providing nutrition is one of the most important aspects of care provided by families for patients with advanced disease with deep meaning in these relationships, especially at the end of life. Oncology nurses provide valuable guidance in these decisions and offer support to both patients and families to ensure quality of life across the trajectory of cancer. 

Evolution in documented goals of care at end of life for adolescents and younger adults with cancerJAMA Network Open; Rosemarie Mastropolo, Colin Cernik, Hajime Uno, Lauren Fisher, Lanfang Xu, Cecile A Laurent, Nancy Cannizzaro, Julie Munneke, Robert M Cooper, Joshua R Lakin, Corey M Schwartz, Mallory Casperson, Andrea Altschuler, Lawrence Kushi, Chun R Chao, Lori Wiener, Jennifer W Mack; 12/24Little is known about the nature of change in goals of care (GOC) over time among adolescents and younger adult (AYA) patients aged 12 to 39 years with cancer near the end of life. Understanding how GOC evolve may guide clinicians in supporting AYA patients in making end-of-life decisions. In this cross-sectional study of AYA patients who died of cancer, palliative goals were rarely documented before the last month of life, highlighting the need for timely and ongoing GOC discussions.

[China] Pharmacist-led management model and medication adherence among patients with chronic heart failure-A randomized clinical trialJAMA Network Open; Lingjiao Wang, MD; Yuanyuan Zhao, MD; Liping Han, MD; Huan Zhang, MD; Hejun Chen, MD; Aixia Liu, MD; Jing Yu, MD; Ran Fu, MD; Liguang Duan, MD; Feiyue An, BS; Zhimin Guo, MD; Yang Lun, BS; Chaoli Chen, BS; Fangfang Cheng, BS; Chaohui Song, BS; Haixia Gao, MD, PhD; Chunhua Zhou, MD, PhD; 12/24Chronic heart failure (CHF) is a complex clinical syndrome that affects approximately 37.7 million people and is a leading cause of morbidity and mortality worldwide. In this randomized clinical trial involving 445 patients with CHF in China, patients who were assigned to a pharmacist-led management intervention showed modest improvement in medication adherence at 52 weeks compared with patients assigned to usual care.

Fall River sees slight uptick in tuberculosis cases. How the city's TB clinic handles it. The Herald News, Fall River, MA; by Emily Scherny; 12/19/24 Tuberculosis is rare in Fall River, though rates of the disease are higher here than the country's average — and it was classified by the World Health Organization as the world's deadliest disease in 2023. Fall River has a TB clinic with a constant presence year-round, serving adult and pediatric patients alike. ... According to the Department of Public Health’s Bureau of Infectious Diseases report that tracks TB cases in the state’s top 25 largest cities, Fall River had approximately 8.5 cases out of every 100,000 residents in 2023; a major uptick after the year before, when none were counted. That compares to the United States average of 2.5 cases per 100,000 that same year. ... TB is very communicable in winter months, Kosior said, which is partly the reason for the 105 CMR state mandate, which dictates stringent measures of managing TB outside of hospitals in outpatient settings.

[Iran] The relationship between the quality of oncology nursing care and the resiliency and hope of patients with cancer: a cross-sectional studyInternational Journal of Palliative Nursing; Nadia Sedri, Mohammad Ali Zakeri, Hakimeh Sheykhasadi, Ala Shamsi, Hosna Akbari, Mostafa Hejazi, Asghar Tavan; 12/24Patients with cancer require emotional support in addition to specialised medical treatments for their physical ailments. The quality of nursing care, resilience and hope can influence a person's cancer trajectory, and understanding these factors and their relationship can be influential in improving the process for these patients. Given the interrelationship between 'resilience' and 'hope' for patients with cancer, it is necessary to focus on the factors that impact these qualities. In addition, paying attention to the concept of resilience can improve the level of hope in patients with cancer. Based on the results, it is recommended that interventions to increase QON [quality of oncology nursing] in patients with cancer be planned and implemented. 

We studied 20 places around the world and found the most common diseases linked with voluntary assisted dying Medical Xpress; by Eliana Close and James Downar, The Conversation; 12/18/24 As of 2023, 282 million people lived in regions where voluntary assisted dying is legal. Jurisdictions such as the Netherlands, Belgium and Oregon have had these laws in place for decades. Other countries, including Canada, Spain, New Zealand and Australia, have passed reforms more recently. ... Debates about voluntary assisted dying are often highly polarized. Understanding the factors driving assisted dying is essential for evidence-based debates and for improving care for people with serious conditions. In a recent study, we examined data from people accessing voluntary assisted dying in 20 jurisdictions around the world. In particular we looked at what diseases they had. ...  With an international team of researchers, we looked at the role disease plays in voluntary assisted dying. We analyzed publicly available data from 20 jurisdictions in eight countries between 1999 and 2023. Overall, most people who accessed voluntary assisted dying had cancer (66.5% of cases). Neurological diseases were the second most common (8.1%), followed by heart (6.8%) and lung (4.9%) conditions. 

Greater education needed to bring palliative care to cancer patients Hospice News; by Jim Parker; 12/18/24 Cancer patients generally need palliative care, but widespread misperceptions often stand in their way, both among the public and many clinicians themselves. This is according to Nadine Barrett, president of the Association of Cancer Care Centers (ACCC). The organization has been holding a series of webinars designed to better educate the oncology community about palliative care. The association is also in the process of studying racial and ethnic gaps in advance care planning, among other projects funded by its research arm, the ACCC Community Oncology Research Institute. Palliative Care News sat down with Barrett to discuss the barriers that cancer patients often experience when it comes to accessing palliative care. [Click on the title's link to read more.]