Yen-Hsuan Hsu1,2, Vincent Chin-Hung Chen3,4, Ching-Chuan Hsieh5,6, Yi-Ping Weng7, Ya-Ting Hsu3, Han-Pin Hsiao3, Wen-Ke Wang8, Hong-Ming Chen3, Jun-Cheng Weng3,9, Shu-I Wu10,11, Michael Gossop12. 1. Department of Psychology, National Chung Cheng University, Chiayi County, Taiwan. 2. Center for Innovative Research on Aging Society (CIRAS), National Chung Cheng University, Chiayi County, Taiwan. 3. Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi County, Taiwan. 4. School of Medicine, Chang Gung University, Taoyuan, Taiwan. 5. Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang-Gung University, Taoyuan, Taiwan. 6. Department of Surgery, Chiayi Chang Gung Memorial Hospital, Puzi, Chiayi County, Taiwan. 7. Breast Center, Chiayi Chang Gung Memorial Hospital and University, Puzi, Chiayi County, Taiwan. 8. Department of Surgery, Taipei Medical University Hospital, Taipei City, Taiwan. 9. Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan City, Taiwan. 10. Department of Medicine, Mackay Medical College, Taipei, Taiwan. shuiwu@g.ntu.edu.tw. 11. Department of Psychiatry, Mackay Memorial Hospital, No. 92, Section 2, Zhongshan North Road, Zhongshan District, Taipei, 104, Taiwan. shuiwu@g.ntu.edu.tw. 12. Institute of Psychiatry, King's College London, London, UK.
Abstract
BACKGROUND: Previous findings regarding declines in cognitive functioning among patients with breast cancer (BC) before and after chemotherapy have been inconsistent. The present study explored the effect of BC and cancer-related chemotherapies on cognitive functioning. METHODS: A cross-sectional design was adopted to compare BC patients before their chemotherapy treatment, BC patients 3 ~ 9 months after the completion of chemotherapy, and noncancer controls. Evaluations of cognitive functioning included subjective and objective dimensions, with focus on memory, executive functioning, attention, and language. ANCOVA and Pearson's correlation analysis were used to examine the relationship among cancer, chemotherapy, cognitive performance, and psychological distress. RESULTS: After adjustment for intelligence quotient, anxiety, and depression, we found significant differences in the Semantic Association of Verbal Fluency between post-chemotherapy (C/T) patients and noncancer controls. Specifically, post-C/T patients scored lower than controls (p = 0.03, η2 = 0.07). No significant differences were found in other objective cognitive measures. However, both subjective and objective cognitive scores were significantly associated with depression, anxiety, and fatigue. In BC patients, levels of anxiety were positively correlated with measures of executive function. Among pre-C/T patients, self-perceived interference by fatigue was positively associated with better performances in some of the objective cognitive measures. CONCLUSION: Our findings suggest cognitive impairments in the domain of executive functioning among patients with BC who received chemotherapy. Providing relevant suggestions or strategies of managements for these negative consequences may help increase the long-term quality of life of patients with BC.
BACKGROUND: Previous findings regarding declines in cognitive functioning among patients with breast cancer (BC) before and after chemotherapy have been inconsistent. The present study explored the effect of BC and cancer-related chemotherapies on cognitive functioning. METHODS: A cross-sectional design was adopted to compare BC patients before their chemotherapy treatment, BC patients 3 ~ 9 months after the completion of chemotherapy, and noncancer controls. Evaluations of cognitive functioning included subjective and objective dimensions, with focus on memory, executive functioning, attention, and language. ANCOVA and Pearson's correlation analysis were used to examine the relationship among cancer, chemotherapy, cognitive performance, and psychological distress. RESULTS: After adjustment for intelligence quotient, anxiety, and depression, we found significant differences in the Semantic Association of Verbal Fluency between post-chemotherapy (C/T) patients and noncancer controls. Specifically, post-C/T patients scored lower than controls (p = 0.03, η2 = 0.07). No significant differences were found in other objective cognitive measures. However, both subjective and objective cognitive scores were significantly associated with depression, anxiety, and fatigue. In BC patients, levels of anxiety were positively correlated with measures of executive function. Among pre-C/T patients, self-perceived interference by fatigue was positively associated with better performances in some of the objective cognitive measures. CONCLUSION: Our findings suggest cognitive impairments in the domain of executive functioning among patients with BC who received chemotherapy. Providing relevant suggestions or strategies of managements for these negative consequences may help increase the long-term quality of life of patients with BC.
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