Multimorbidity, non-specific symptoms, and atypical disease manifestations are common in adults aged 65 years or older, complicating diagnostic and prognostic assessment. Point-of-care ultrasound (POCUS) provides real-time bedside imaging that can support clinical decision making in this population; however, evidence on its use in older adults has not been systematically mapped. This scoping Review, endorsed by the European Geriatric Medicine Society, mapped POCUS utilisation across health-care settings, application domains, clinical indications, and outcomes. MEDLINE, Scopus, and Web of Science were systematically searched. Eligible studies were peer-reviewed original research articles investigating the use of POCUS in older adults (defined as studies that exclusively enrolled older adults ≥65 years or reported a mixed-age study population with a mean age of 65 years or older) and published in English or another language represented within the review team (Italian, French, German, Spanish, Danish, or Turkish) with no restrictions on publication date. Of the 3897 records, 240 (6%) studies were included; 87 (36%) focused on older adult or geriatric-targeted populations and 153 (64%) on mixed-age populations with a mean age of 65 years or older. Evidence came predominantly from acute care, with few studies in geriatric settings. Thoracic POCUS was the most frequently investigated single-organ domain; multiorgan POCUS was also prominent. Diagnostic support and prognostic stratification predominated, whereas longitudinal monitoring and patient-centred outcomes were infrequent. Evidence on POCUS applications in older adults remains uneven, highlighting the need for further research in under-represented geriatric care settings and on patient-centred outcomes.
Background As the global population ages, the prevalence of both cancer and dementia continues to increase. We aimed to assess the effect of pre-existing dementia on cancer-specific and all-cause mortality among individuals diagnosed with cancer. Methods We conducted a population-based matched cohort study of Danish citizens using data from Danish health and administrative registries. We included all individuals diagnosed with cancer in Denmark between Jan 1, 1995, and Dec 31, 2022 and identified dementia diagnoses recorded before their cancer diagnosis. Individuals were excluded if they had an invalid civil personal registration number, did not have a Danish address before their cancer diagnosis, or had a cancer diagnosis recorded after death or emigration. Patients with cancer without comorbid dementia were randomly selected with replacement from the cohort and matched to patients with cancer and comorbid dementia by cancer site, age, sex, and calendar period, in a 5:1 ratio. We estimated 5-year mortality risk, risk differences (RDs), and multivariable-adjusted hazard ratios (HRs) with 95% CIs for the association between comorbid dementia and cancer-specific and all-cause mortality, overall and across key patient and cancer characteristics. Findings We identified 17 425 patients with cancer and comorbid dementia and 86 823 patients with cancer without comorbid dementia. Patients with cancer and comorbid dementia had a 5-year cancer-specific mortality of 44·0% (95% CI 43·2–44·7) compared with 39·4% (39·1–39·8) among patients with cancer without comorbid dementia (RD 4·5%, 95% CI 3·7–5·4), and an excess 5-year all-cause mortality (22·2%, 21·5–22·9). Excess cancer-specific mortality associated with dementia was the highest among patients with colon cancer (RD 13·8%, 95% CI 10·8–16·7), rectal cancer (RD 14·8%, 95% CI 10.3–19.2), and breast cancer (RD 8·9%, 95% CI 6·3–11·5%). Comparison of patients with cancer and comorbid dementia with patients those with cancer alone revealed higher cancer-specific mortality (multivariable-adjusted HR 1·28, 95% CI 1·24–1·31) and all-cause mortality (2·03, 1·98–2·07) among patients with cancer and dementia. Interpretation Cancer-specific and all-cause mortality rates were elevated among individuals with cancer and dementia. As treatments continue to improve survival outcomes for people with cancer and dementia, clinical guidelines for cancer screening and treatment in individuals living with dementia should be developed. Funding National Institutes of Health, Aarhus University.
