Adele Crouch1, Victoria L Champion2, Frederick W Unverzagt3, Susan J Pressler4, Lesa Huber5, Lyndsi R Moser6, David Cella7, Diane Von Ah8. 1. Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA. Electronic address: adnielse@iu.edu. 2. Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA. Electronic address: vchampio@iu.edu. 3. Indiana University School of Medicine, 355 W. 16th Street, Indianapolis, IN 46202, USA. Electronic address: funverza@iupui.edu. 4. Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA. Electronic address: sjpress@iu.edu. 5. Indiana University School of Public Health, 1025 E. 7(th) Street, Bloomington, IN 47405, USA. Electronic address: lehuber@indiana.edu. 6. Indiana University School of Medicine, 355 W. 16th Street, Indianapolis, IN 46202, USA. Electronic address: lrhabegg@iupui.edu. 7. Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave - 21(st) Floor, Chicago, IL 60611, USA. Electronic address: d-cella@northwestern.edu. 8. Indiana University School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA. Electronic address: dvonah@iu.edu.
Abstract
OBJECTIVES: The purpose of this study was to examine the prevalence and factors associated with objective and subjective cognitive dysfunction in older breast cancer survivors (BCS). MATERIALS AND METHODS: This cross-sectional descriptive study leveraged previously collected data from older BCS (n = 335). Separate linear regression models were used to determine relationships between demographic factors (age, education), medical factors (comorbidities), disease factors (time since diagnosis, cancer stage), cancer-related symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and cognitive dysfunction measures, including objective learning, delayed recall, attention, executive function-working memory, verbal fluency and subjective attentional function. RESULTS: Cognitive dysfunction was prevalent with up to 18.6% of older BCS experiencing mild-moderate dysfunction (1.5 standard deviations below mean of non-cancer controls) in at least one cognitive domain. Poor to moderate subjective attentional function was reported by 26% of older BCS. More depressive symptoms were significantly related to poorer cognitive function including learning (p < .01), delayed recall (p < .05), verbal fluency (p < .001), and subjective attentional function (p < .001) but not attention and executive function-working memory. Age, education, anxiety, and fatigue were also negatively associated with cognitive function in some models (p < .05-0.001). CONCLUSION: Cognitive dysfunction is common among older BCS and depressive symptoms, anxiety, and fatigue are related factors. Importantly, depressive symptoms were not only related to self-report, but also to cognitive performance. Healthcare providers should be aware of and assess for related factors and cognitive dysfunction itself in older BCS even years after diagnosis and treatment thorough geriatric assessment. Future longitudinal research is needed to discern these relationships.
OBJECTIVES: The purpose of this study was to examine the prevalence and factors associated with objective and subjective cognitive dysfunction in older breast cancer survivors (BCS). MATERIALS AND METHODS: This cross-sectional descriptive study leveraged previously collected data from older BCS (n = 335). Separate linear regression models were used to determine relationships between demographic factors (age, education), medical factors (comorbidities), disease factors (time since diagnosis, cancer stage), cancer-related symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and cognitive dysfunction measures, including objective learning, delayed recall, attention, executive function-working memory, verbal fluency and subjective attentional function. RESULTS: Cognitive dysfunction was prevalent with up to 18.6% of older BCS experiencing mild-moderate dysfunction (1.5 standard deviations below mean of non-cancer controls) in at least one cognitive domain. Poor to moderate subjective attentional function was reported by 26% of older BCS. More depressive symptoms were significantly related to poorer cognitive function including learning (p < .01), delayed recall (p < .05), verbal fluency (p < .001), and subjective attentional function (p < .001) but not attention and executive function-working memory. Age, education, anxiety, and fatigue were also negatively associated with cognitive function in some models (p < .05-0.001). CONCLUSION: Cognitive dysfunction is common among older BCS and depressive symptoms, anxiety, and fatigue are related factors. Importantly, depressive symptoms were not only related to self-report, but also to cognitive performance. Healthcare providers should be aware of and assess for related factors and cognitive dysfunction itself in older BCS even years after diagnosis and treatment thorough geriatric assessment. Future longitudinal research is needed to discern these relationships.
Authors: N Biglia; V E Bounous; A Malabaila; D Palmisano; D M E Torta; M D'Alonzo; P Sismondi; R Torta Journal: Eur J Cancer Care (Engl) Date: 2011-12-28 Impact factor: 2.520
Authors: Supriya G Mohile; William Dale; Mark R Somerfield; Mara A Schonberg; Cynthia M Boyd; Peggy S Burhenn; Beverly Canin; Harvey Jay Cohen; Holly M Holmes; Judith O Hopkins; Michelle C Janelsins; Alok A Khorana; Heidi D Klepin; Stuart M Lichtman; Karen M Mustian; William P Tew; Arti Hurria Journal: J Clin Oncol Date: 2018-05-21 Impact factor: 44.544
Authors: Jeanne S Mandelblatt; Brent J Small; Gheorghe Luta; Arti Hurria; Heather Jim; Brenna C McDonald; Deena Graham; Xingtao Zhou; Jonathan Clapp; Wanting Zhai; Elizabeth Breen; Judith E Carroll; Neelima Denduluri; Asma Dilawari; Martine Extermann; Claudine Isaacs; Paul B Jacobsen; Lindsay C Kobayashi; Kelly Holohan Nudelman; James Root; Robert A Stern; Danielle Tometich; Raymond Turner; John W VanMeter; Andrew J Saykin; Tim Ahles Journal: J Clin Oncol Date: 2018-10-03 Impact factor: 44.544
Authors: Yu-Yin Allemann-Su; Marcus Vetter; Helen Koechlin; Steven M Paul; Bruce A Cooper; Kate Oppegaard; Michelle Melisko; Jon D Levine; Yvette Conley; Christine Miaskowski; Maria C Katapodi Journal: Cancers (Basel) Date: 2022-07-05 Impact factor: 6.575