老年人患有阿尔茨海默病和相关痴呆症（ADRD），并被诊断出患有癌症的情况是一个研究不足的群体。尽管认知功能损害在癌症治疗期间和之后的作用已经得到了广泛的研究，但对那些患有ADRD并后来患癌症的患者了解不足。本研究的目的是为了增加我们对这一脆弱人群的理解的证据。这是一项回顾性队列研究，使用了SEER-Medicare数据库的癌症登记数据库和医疗保险索赔数据库的联合、代表性家族数据库。年龄在68岁及以上的老年人，首次患有乳腺、宫颈、结直肠、肺、口腔或前列腺癌的患者符合纳入标准（N = 337,932）。通过患者因素比较各种癌症类型的ADRD患病率估计和5％非癌症对照样本的比较。在癌症诊断前三年内曾被诊断出ADRD的患者的总患病率为5.6％。患有ADRD的患者更有可能是女性、年龄较大（超过75岁）、种族/民族少数群体、单身、有多种慢性病并早期诊断（I期）或未分期的肿瘤。与白人患者相比，黑人结直肠癌和口腔癌患者的ADRD患病率最高，分别为13.46％和7.95％，以及12.64％和7.82％（P < .0001）。我们观察到黑人乳腺癌（11.85％）、宫颈癌（11.98％）、肺癌（8.41％）、前列腺癌（4.83％）和5％样本（9.50％，P > .0001）的ADRD患病率最高。黑人和拉丁裔老年癌症患者的ADRD患病率较高不仅与我们的非癌症对照样本的趋势相一致，而且这些发现也展示了少数族裔老年人在整个生命周期中所面临的复合风险。ADRD患者中有癌症的患病率高于预期，这表明迫切需要更好地评估认知功能。准确识别这些脆弱人群对于改善评估、协调护理和解决筛查和治疗计划不平等至关重要。（版权所有©2023由Elsevier Ltd.出版）。

Older adults living with Alzheimer's disease and related dementias (ADRD) who are then diagnosed with cancer are an understudied population. While the role of cognitive impairment during and after cancer treatment have been well-studied, less is understood about patients who are living with ADRD and then develop cancer. The purpose of this study is to contribute evidence about our understanding of this vulnerable population.This was a retrospective cohort study of a linked, representative family of databases of cancer registries and Medicare administrative claims that make up the SEER-Medicare database. Older adults ages 68 and older with a first primary cancer type: breast, cervical, colorectal, lung, oral, or prostate were eligible for inclusion (N = 337,932). Prevalence estimates of ADRD across cancer types and a 5% non-cancer comparison sample were compared by patient factors.The overall prevalence of patients who had an ADRD diagnosis anytime in the three years prior to their cancer diagnosis was 5.6%. Patients with ADRD were more likely to be female, older (over age 75), a racial/ethnic minority, single, with multiple chronic conditions, and a tumor diagnosed early (stage I) or were unstaged. Black patients with colorectal and oral cancer had the highest and second highest prevalence of ADRD compared to White patients (13.46% vs 7.95% and 12.64% vs 7.82% respectively, p < .0001). We observed the highest prevalence of ADRD among Black patients for breast (11.85%), cervical (11.98%), lung (8.41%), prostate (4.83), and the 5% sample (9.50%, p > .0001).The higher prevalence of ADRD among Black and Latine older adults with cancer not only aligns with the trend observed in our non-cancer comparison sample, but also, these findings demonstrate the compounded risk experienced by minoritized older adults over the life course. The greater than expected prevalence of patients with ADRD who go on to develop cancer demonstrates better assessment of cognition is urgently needed. Accurate identification of these vulnerable populations is critical to improve assessment, care coordination, and address inequities in screening and treatment planning.Copyright © 2023. Published by Elsevier Ltd.