According to data largely obtained from retrospective studies, it has been postulated that chemotherapy exerts an aggravating effect on the cognitive function of patients with breast cancer. Potential individual factors related to the effects of chemotherapy on cognitive function have been indicated, such as age-related cognitive dysfunction and stress. Elderly patients differ from non-elderly patients as regards higher cognitive related comorbidities, such as dementia, as well as regarding lower stress levels, indicating that ‘chemobrain’ may differentially affect these two age groups. The aim of this review was to discuss the effects of stress and chemotherapy on cognitive dysfunction and identify any potential age-related differences in patients with breast cancer treated with adjuvant chemotherapy. For this purpose, a systematic review of the literature was carried out on the PubMed, Scopus and Web of Science databases. The inclusion criteria were original articles published in peer-reviewed journals, elderly and non-elderly patients with breast cancer, reporting on stress and at least one cognitive parameter pre- and/or post-treatment. Eight studies met the preset criteria and were further analyzed. In total, the data of 1,253 women were included, of whom 800 patients with breast cancer were treated with surgery only, systemic treatment only, or both. Although all the studies included a non-elderly breast cancer patient subpopulation, only two of the studies included patients over 65 years of age. All studies indicated a statistically significant association of stress with various domains of cognitive dysfunction in patients, as shown by either self-completed questionnaires, neuropsychological testing or both. An age over 60 years was linked to fewer cognitive difficulties mediated by lower levels of stress. Thus, the evidence supports the association of stress with cognitive deficits in patients with breast cancer, regardless of the type of cancer-related treatment. Therefore, stress should be appropriately addressed. However, further research is required to investigate the association of stress with cognitive function in elderly patients with breast cancer.
Severe economic crisis seems to increase the rates of suicide attempts. The need for more detailed investigation is essential to provide insight into this global problem.
Alzheimer's disease is a progressive neurodegenerative disorder which is characterized by the progressive decline in memory and other cognitive abilities. Behavioral and personality changes can also be present. Depression is also a neuropsychiatric aspect of Alzheimer's disease.
Objective:The aim of this study is to compare the effect of risperidone as monotherapy in patients with behavioral problems, sertraline as monotherapy in patients with depression and with the combination of cholinesterase inhibitors on cognitive functioning due to Alzheimer's Disease.
Methods and Participants:The study comprised 78 participants diagnosed with AD, all over fifty years of age. The participants were split into 4 groups: groups A and B had everyday behavioral problems, while groups C and D had co-morbid depression. Group A was treated with risperidone 1mg daily, group B with risperidone and cholinesterase inhibitors, Group C was treated with sertraline, and group D with sertraline and cholinesterase inhibitors. Baseline assessment of groups A and B was performed using the instrumental activities of daily living (IADL) Scale, Physical Self-Maintenance Scale (PSMS), Mini-Mental State Examination Scale (MMSE), while a follow-up assessment after three and six months was only with MMSE. Groups C and D were assessed with MMSE and the Montgomery-Asberg Depression Rating Scale for baseline assessment and follow-up after 12 months.Results: It was found that group A (treated with risperidone only) showed a statistically significant improvement in MMSE scores with respect to the baseline assessment after 6 months, An improvement not seen in group B (treated with risperidone and cholinesterase inhibitors). Groups C and D did not show any significant improvement in scores on either assessment scale.
Conclusion:Risperidone used as monotherapy displayed a positive effect on cognitive function due to Alzheimer's.
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