Mariana Ramalho1, Filipa Fontes2, Luís Ruano3, Susana Pereira4, Nuno Lunet5. 1. Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal. 2. ISPUP - EPIUnit, Universidade do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal. 3. ISPUP - EPIUnit, Universidade do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. 4. ISPUP - EPIUnit, Universidade do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal; Instituto Português de Oncologia do Porto, Rua Dr. António Bernardino de Almeida, 4200-075, Porto, Portugal. 5. ISPUP - EPIUnit, Universidade do Porto, Rua das Taipas, nº135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. Electronic address: nlunet@med.up.pt.
Abstract
OBJECTIVES: The objective of this study was to assess the relation between cancer treatments and incident cognitive impairment in breast cancer patients, taking into account the levels of anxiety before treatment. MATERIALS AND METHODS: We conducted a prospective cohort study with 418 newly diagnosed breast cancer patients with no cognitive impairment, defined as values at least 1.5 standard deviations below age- and education-adjusted cut-offs in the Montreal Cognitive Assessment (MoCA), at baseline. The Hospital Anxiety and Depression Scale and MoCA were used for evaluations before treatment and at 1-year after diagnosis. We used Poisson regressions to compute adjusted relative risks (RR) and corresponding 95% confidence intervals (95%CI) to identify predictors of cognitive impairment. RESULTS: The median (Percentile 25, Percentile 75) MoCA score before treatment was 24 (21, 26). A total of 8.1% (95%CI: 5.8, 11.2) of the patients presented incident cognitive impairment during the follow-up. There was a statistically significant interaction between anxiety at baseline and the effect of chemotherapy on the incidence of cognitive impairment (P for interaction = 0.028). There was a significantly increased risk of incident cognitive impairment among patients with no anxiety prior to treatment with schemes including doxorubicin and cyclophosphamide (adjusted RR = 4.22, 95%CI: 1.22, 14.65). CONCLUSION: There was a statistically significant association between chemotherapy and cognitive impairment, but only among women with no anxiety at baseline.
OBJECTIVES: The objective of this study was to assess the relation between cancer treatments and incident cognitive impairment in breast cancerpatients, taking into account the levels of anxiety before treatment. MATERIALS AND METHODS: We conducted a prospective cohort study with 418 newly diagnosed breast cancerpatients with no cognitive impairment, defined as values at least 1.5 standard deviations below age- and education-adjusted cut-offs in the Montreal Cognitive Assessment (MoCA), at baseline. The Hospital Anxiety and Depression Scale and MoCA were used for evaluations before treatment and at 1-year after diagnosis. We used Poisson regressions to compute adjusted relative risks (RR) and corresponding 95% confidence intervals (95%CI) to identify predictors of cognitive impairment. RESULTS: The median (Percentile 25, Percentile 75) MoCA score before treatment was 24 (21, 26). A total of 8.1% (95%CI: 5.8, 11.2) of the patients presented incident cognitive impairment during the follow-up. There was a statistically significant interaction between anxiety at baseline and the effect of chemotherapy on the incidence of cognitive impairment (P for interaction = 0.028). There was a significantly increased risk of incident cognitive impairment among patients with no anxiety prior to treatment with schemes including doxorubicin and cyclophosphamide (adjusted RR = 4.22, 95%CI: 1.22, 14.65). CONCLUSION: There was a statistically significant association between chemotherapy and cognitive impairment, but only among women with no anxiety at baseline.
Authors: M Lange; F Joly; J Vardy; T Ahles; M Dubois; L Tron; G Winocur; M B De Ruiter; H Castel Journal: Ann Oncol Date: 2019-12-01 Impact factor: 32.976
Authors: Nicole Rodriguez; Jonathan M Fawcett; Joshua A Rash; Renee Lester; Erin Powell; Connor D MacMillan; Sheila N Garland Journal: Cancer Med Date: 2021-01-16 Impact factor: 4.452
Authors: Ana Dias-Carvalho; Mariana Ferreira; Rita Ferreira; Maria de Lourdes Bastos; Susana Isabel Sá; João Paulo Capela; Félix Carvalho; Vera Marisa Costa Journal: Arch Toxicol Date: 2021-11-02 Impact factor: 5.153
Authors: N Araújo; A Costa; L Lopes-Conceição; A Ferreira; F Carneiro; J Oliveira; I Braga; S Morais; L Pacheco-Figueiredo; L Ruano; V T Cruz; S Pereira; N Lunet Journal: ESMO Open Date: 2022-03-07