Change in cognition before and after non‐central nervous system cancer diagnosis: A population‐based cohort study

Willik, Kimberly D. van der; Jóźwiak, Katarzyna; Hauptmann, Michael; Velde, Edolie E.D. van de; Compter, Annette; Ruiter, Rikje; Stricker, Bruno H. Ch.; Ikram, M. Arfan; Schagen, Sanne B.

doi:10.1002/pon.5734

Cited by 3 publications

(4 citation statements)

References 38 publications

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“…In non-CNS tumor patients, local therapy (surgery or radiotherapy) did not have a substantial impact on cognition [29][30][31][32][33][34]. Only for sinonasal and gynecological cancers, impaired cognitive functioning was found after radiotherapy and/or surgery [19,35].…”

Section: Neuropsychological Testingmentioning

confidence: 99%

A Systematic Review on the Potential Acceleration of Neurocognitive Aging in Older Cancer Survivors

Kerstens

Wildiers

Schroyen

et al. 2023

Cancers

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As survival rates increase, more emphasis has gone to possible cognitive sequelae in older cancer patients, which could be explained by accelerated brain aging. In this review, we provide a complete overview of studies investigating neuroimaging, neurocognitive, and neurodegenerative disorders in older cancer survivors (>65 years), based on three databases (Pubmed, Web of Science and Medline). Ninety-six studies were included. Evidence was found for functional and structural brain changes (frontal regions, basal ganglia, gray and white matter), compared to healthy controls. Cognitive decline was mainly found in memory functioning. Anti-hormonal treatments were repeatedly associated with cognitive decline (tamoxifen) and sometimes with an increased risk of Alzheimer’s disease (androgen deprivation therapy). Chemotherapy was inconsistently associated with later development of cognitive changes or dementia. Radiotherapy was not associated with cognition in patients with non-central nervous system cancer but can play a role in patients with central nervous system cancer, while neurosurgery seemed to improve their cognition in the short-term. Individual risk factors included cancer subtypes (e.g., brain cancer, hormone-related cancers), treatment (e.g., anti-hormonal therapy, chemotherapy, cranial radiation), genetic predisposition (e.g., APOE, COMT, BDNF), age, comorbidities (e.g., frailty, cognitive reserve), and psychological (e.g., depression, (post-traumatic) distress, sleep, fatigue) and social factors (e.g., loneliness, limited caregiver support, low SES). More research on accelerated aging is required to guide intervention studies.

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Section: Neuropsychological Testingmentioning

confidence: 99%

A Systematic Review on the Potential Acceleration of Neurocognitive Aging in Older Cancer Survivors

Kerstens

Wildiers

Schroyen

et al. 2023

Cancers

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“…Thirty-nine studies (60%) examined cognitive functional outcomes among cancer survivors; 32 were longitudinal in design ( 77,78,81]. Six of these studies (n = 6/16; 37%) reported clinically meaningful differences between survivors and controls [22,31,42,49,70,73].…”

Section: Studies Examining Cognitive Functional Outcomes Among Cancer...mentioning

confidence: 99%

“…Six of these studies (n = 6/16; 37%) reported clinically meaningful differences between survivors and controls [22,31,42,49,70,73]. Only three studies (n = 3/19; 16%) found no difference in cognitive functional outcomes pre-to post-chemotherapy or between those who received chemotherapy and the healthy control groups [37,78,81].…”

Section: Studies Examining Cognitive Functional Outcomes Among Cancer...mentioning

confidence: 99%

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A scoping review evaluating physical and cognitive functional outcomes in cancer survivors treated with chemotherapy: charting progress since the 2018 NCI think tank on cancer and aging phenotypes

Mohamed,

Ahmed,

Williams

et al. 2024

J Cancer Surviv

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Purpose The primary goal of this scoping review was to summarize the literature published after the 2018 National Cancer Institute think tank, “Measuring Aging and Identifying Aging Phenotypes in Cancer Survivors,” on physical and cognitive functional outcomes among cancer survivors treated with chemotherapy. We focused on the influence of chemotherapy on aging-related outcomes (i.e., physical functional outcomes, cognitive functional outcomes, and frailty), given the known associations between chemotherapy and biologic mechanisms that affect aging-related physiologic processes. Methods A search was conducted across electronic databases, including PubMed, Scopus, and Web of Science, for manuscripts published between August 2018 and July 2023. Eligible studies: 1) included physical function, cognitive function, and/or frailty as outcomes; 2) included cancer survivors (as either the whole sample or a subgroup); 3) reported on physical or cognitive functional outcomes and/or frailty related to chemotherapy treatment (as either the whole sample or a subgroup); and 4) were observational in study design. Results The search yielded 989 potentially relevant articles, of which 65 met the eligibility criteria. Of the 65 studies, 49 were longitudinal, and 16 were cross-sectional; 30 studies (46%) focused on breast cancer, 20 studies (31%) focused on the age group 60 + years, and 17 (26%) focused on childhood cancer survivors. With regards to outcomes, 82% of 23 studies reporting on physical function showed reduced physical function, 74% of 39 studies reporting on cognitive functional outcomes found reduced cognitive function, and 80% of 15 studies reporting on frailty found increasing frailty among cancer survivors treated with chemotherapy over time and/or compared to individuals not treated with chemotherapy. Fourteen studies (22%) evaluated biologic mechanisms and their relationship to aging-related outcomes. Inflammation was consistently associated with worsening physical and cognitive functional outcomes and epigenetic age increases. Further, DNA damage was consistently associated with worse aging-related outcomes. Conclusion Chemotherapy is associated with reduced physical function, reduced cognitive function, and an increase in frailty in cancer survivors; these associations were demonstrated in longitudinal and cross-sectional studies. Inflammation and epigenetic age acceleration are associated with worse physical and cognitive function; prospective observational studies with multiple time points are needed to confirm these findings. Implications for cancer survivors This scoping review highlights the need for interventions to prevent declines in physical and cognitive function in cancer survivors who have received chemotherapy.

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Routine Cancer Treatment Regimens and Its Impact on Fine Motor Dexterity in Breast Cancer

et al. 2021

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Introduction: Breast cancer can be a major challenge for those affected. Knowledge of changes in fine motor dexterity in affected women due to routine cancer therapies can help guide effective support. Methods: For this prospective observational study, we collected data of 79 women with a mean age 54.6 ± 9.5 years prior to, after breast cancer therapy (T1), and at 3-month follow-up. The fine motor dexterity was assessed for 4 treatment subgroups: SC = Surgery + Chemotherapy, SCR = Surgery + Chemotherapy + Radiotherapy Therapy, SR = Surgery + Radiotherapy, and S = Surgery. Results: Over time, women with breast cancer showed significant decreases in fine motor dexterity across all treatment groups (p < 0.001). The strongest negative effect was seen in the treatment groups receiving additional chemotherapy. SCR group showed pronounced limitations for dominant hand (DH) −12%; non-dominant hand (NDH) −15%; both hands (BH) −17%; assembly (ASSY) −11% at T1. Significant interaction was noticeable in DH (F = 5.59, p < 0.001), NDH (F = 6.61, p < 0.001), BH (F = 13.11 p < 0.001), and ASSY (F = 5.84 p < 0.001). Discussion/Conclusion: Our study showed that the extent of change in fine motor dexterity depends on the treatment regimen. The detection of unmet care needs could help to personalize and optimize clinical and survivorship care. Based on our findings, multidisciplinary support initiated early in breast cancer therapy is required.

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Change in cognition before and after non‐central nervous system cancer diagnosis: A population‐based cohort study

Cited by 3 publications

References 38 publications

A Systematic Review on the Potential Acceleration of Neurocognitive Aging in Older Cancer Survivors

A Systematic Review on the Potential Acceleration of Neurocognitive Aging in Older Cancer Survivors

A scoping review evaluating physical and cognitive functional outcomes in cancer survivors treated with chemotherapy: charting progress since the 2018 NCI think tank on cancer and aging phenotypes

Routine Cancer Treatment Regimens and Its Impact on Fine Motor Dexterity in Breast Cancer

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