BACKGROUND
Cognitive impairment among patients with Glioblastoma Multiforme (GBM) is clinically recognised but limited data exists to define the scope of the problem.(1) Cognitive dysfunction may be the first manifestation of tumour recurrence with significant impact on patients’ quality-of-life.(1-4) Recognising neurocognitive dysfunction is important in assessing decision-making capacity and cognitive rehabilitation may be beneficial for GBM patients.(5-7) Cognitive impairment is not routinely assessed with no standard to assess the degree of cognitive impairment amongst GBM patients.(8)
Objective
Assess the current levels of cognitive assessments that are occurring in clinical practice by reviewing the number and types of cognitive assessment performed in this patient group. Results may inform future recommendations for cognitive assessment in patient care.
Methods
We undertook a retrospective study and identified patients above the age of 18 with newly diagnosed GBM, who were reviewed by the medical oncology team in Sir Charles Gairdner Hospital (SCGH) from September 2016 to January 2018. Patients with established impairment or unsuitable for further chemotherapy were excluded. We reviewed patients’ electronic and physical medical records to evaluate if any cognitive assessment was performed over a 24-month period.
Results
Of the 51 patients identified, 36 patients were included in this audit based on the inclusion and exclusion criteria. 8 of the 36 patients had formal cognitive assessments completed within 24 months of diagnosis. The Mini-Mental State Examination was the most used cognitive assessment tool. Of 11 patients noted to have cognitive decline, only one patient underwent formal cognitive assessment.
Conclusions
Our audit confirms that cognitive assessment is not routine in the assessment of patients with GBM with only a minority of patients undergoing any form of cognitive testing. This concerningly included patients who were documented to have demonstrated signs of cognitive decline.