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Cognitive dysfunction prevalence and associated factors in older breast cancer survivors

Year: 2021
Type: article
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.
DOI: 10.1016/j.jgo.2021.07.001
Authors: Adele Crouch, Victoria L. Champion, Frederick W. Unverzagt, Susan J. Pressler, Lesa Huber, Lyndsi R. Moser, David Cella, Diane Von Ah
Institutions: Indiana University Indianapolis, Indiana University School of Medicine, Indiana University Bloomington, Indiana University, Indiana University – Purdue University Indianapolis, Northwestern University
Language: English
Field: Medicine
Open Access status: hybrid
Estimated APC paid: $3,000
Funders: U.S. Department of Health and Human Services, American Cancer Society, Oncology Nursing Society, Oncology Nursing Society Foundation, Purdue University, American College of Radiology Imaging Network, Indiana University-Purdue University Indianapolis, ECOG-ACRIN Cancer Research Group, National Institutes of Health, U.S. Public Health Service, National Cancer Institute
Awards: G1969521011, G4413867291, ECOG-ACRIN NCORP Research Base, G5016923537, G5353277914, Building upon a tradition of excellence. The NCTN at Indiana University, Interdisciplinary Training in Cancer Prevention and Control
OpenAlex ID: W3182015630
FWCI: 1.837
Cites: 54
Cited by: 25
Related to: 10