Cancer-related cognitive impairment (CRCI) refers to cancer-related changes in memory, executive functioning, speed of information processing, decision-making, and other cognitive functions that are experienced by up to 75% of cancer survivors [1]. CRCI is theorised to be caused and maintained by the physiological effects of cancer and cancer treatments, as well as the severity of psychological distress (i.e., depression, anxiety and stress), and the impairments can last decades after treatment completion [2]. CRCI can have considerable negative consequences on the lives of cancer survivors, with quantitative and qualitative evidence consistently showing CRCI to commonly impact activities of daily living, social and relational functioning, occupational and vocational functioning, and psychological well-being [3]. For older people affected by CRCI, there can be particularly elevated concerns in the domain of independence. Additionally, among older adults affected by CRCI, it is common for concerns to arise about whether these cognitive changes may signal the onset of dementia [4]. The majority of research and clinical care in CRCI has focused on the assessment and determination of CRCI and its severity, along with developing and testing interventions which aim to reduce CRCI. Until recently, no purpose-built tool existed to understand the specific unmet needs relating to CRCI to help facilitate tailored supportive care to manage the impact of CRCI. This presentation will discuss the separation between CRCI severity and CRCI-related unmet needs, the development of the MASCC COG-IMPACT Tool [4], and how this relates to the assessment and care of older people affected by CRCI.