Anne Van Arsdale1, Debra Rosenbaum1, Gurpreet Kaur1, Priya Pinto2, Dennis Yi-Shin Kuo3, Ruben Barrera1, Gary L Goldberg3, Nicole S Nevadunsky4. 1. Montefiore Medical Center, Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States. 2. Montefiore Medical Center, Department of Family Medicine, Palliative Medicine, Bronx, NY, United States. 3. Montefiore Medical Center, Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States. 4. Montefiore Medical Center, Division of Gynecologic Oncology, Department of Obstetrics & Gynecology and Women's Health, Bronx, NY, United States; Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, NY, United States. Electronic address: nnevadun@montefiore.org.
Abstract
OBJECTIVE: Cognitive impairment has implications in counseling, treatment, and survivorship for women with gynecologic malignancies. The purpose of our study was to evaluate the prevalence and risk factors associated with cognition in women with gynecologic malignancies. METHODS: After Institutional Review Board approval, 165 women at an urban ambulatory gynecologic oncology facility were queried using a Montreal Cognitive Assessment (MoCA), Wong-Baker pain scale, neuropathy scale, Patient Health Questionnaire 9 (PHQ-9) Depression Scale, and Generalized Anxiety Disorder Scale (GAD 7). Univariate and multivariate analyses were utilized to evaluate the association of cognitive deficit with age, education, race/ethnicity, disease site, stage, treatment, pain, neuropathy, anxiety, and depression. RESULTS: The mean MoCA score for the entire cohort was 24.1 (range 13-30.) 24% of patients had MoCA scores less than 22. Low scores (<22) were associated with older age, non-white race/ethnicity, lower education level, uterine and vulvar cancers, and pain ≥5 (p<0.05). There was a trend toward lower cognition scores for women treated with both chemotherapy and radiation (p=0.10). While clinically significant pain was associated with low cognition, there was no association with use of opioid pain medication and low cognition scores. CONCLUSIONS: There was a high prevalence of cognitive deficit in women with gynecologic malignancies. The association of low cognition with report of clinically significant pain, but not with use of opioid pain medications, should be further explored. Research is needed to evaluate the impact of cognitive deficits on treatment adherence and outcomes for women with gynecologic malignancies.
OBJECTIVE:Cognitive impairment has implications in counseling, treatment, and survivorship for women with gynecologic malignancies. The purpose of our study was to evaluate the prevalence and risk factors associated with cognition in women with gynecologic malignancies. METHODS: After Institutional Review Board approval, 165 women at an urban ambulatory gynecologic oncology facility were queried using a Montreal Cognitive Assessment (MoCA), Wong-Baker pain scale, neuropathy scale, Patient Health Questionnaire 9 (PHQ-9) Depression Scale, and Generalized Anxiety Disorder Scale (GAD 7). Univariate and multivariate analyses were utilized to evaluate the association of cognitive deficit with age, education, race/ethnicity, disease site, stage, treatment, pain, neuropathy, anxiety, and depression. RESULTS: The mean MoCA score for the entire cohort was 24.1 (range 13-30.) 24% of patients had MoCA scores less than 22. Low scores (<22) were associated with older age, non-white race/ethnicity, lower education level, uterine and vulvar cancers, and pain ≥5 (p<0.05). There was a trend toward lower cognition scores for women treated with both chemotherapy and radiation (p=0.10). While clinically significant pain was associated with low cognition, there was no association with use of opioid pain medication and low cognition scores. CONCLUSIONS: There was a high prevalence of cognitive deficit in women with gynecologic malignancies. The association of low cognition with report of clinically significant pain, but not with use of opioid pain medications, should be further explored. Research is needed to evaluate the impact of cognitive deficits on treatment adherence and outcomes for women with gynecologic malignancies.
Authors: Marita Partanen; Nicole M Alberts; Heather M Conklin; Kevin R Krull; Ching-Hon Pui; Doralina A Anghelescu; Lisa M Jacola Journal: Pain Date: 2021-09-25 Impact factor: 7.926