Cognitive dysfunction prevalence and associated factors in older breast cancer survivors

Abstract

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.

Association Between Cardiovascular Disease and Cognitive Dysfunction in Breast Cancer Survivors

“…The neuropsychological test battery included objective tests of memory and delayed memory, attention and working memory, speed of processing, and verbal fluency/executive functioning. These tests are reliable and valid instruments that have been used previously with BCSs 32–35 . Memory and delayed memory were measure by the Rivermead Behavioral Paragraph Recall Test, which is a story recall test that was used to test verbal memory 36 .…”

“…These tests are reliable and valid instruments that have been used previously with BCSs. [32][33][34][35] Memory and delayed memory were measure by the Rivermead Behavioral Paragraph Recall Test, which is a story recall test that was used to test verbal memory. 36 Participants listened to a short passage read aloud and were then asked to write down as much as they can remember both immediately and again 30 minutes later (delayed memory).…”

Prevalence and associated factors of chemotherapy‐related cognitive impairment in older breast cancer survivors

“…was connected with subjective attention function (Crouch, Champion, Unverzagt, et al, 2022;Zhang et al, 2020). Further, significant longitudinal associations were observed between frailty and subjective cognitive complaints (p < .001; Mandelblatt et al, 2018) as well Red: low quality (0-3) Yellow: medium quality (4-6) Green: high quality (7-9)…”

Pre-Surgery Demographic, Clinical, and Symptom Characteristics Associated with Different Self-Reported Cognitive Processes in Patients with Breast Cancer

“…Working memory, selective attention, and self-control can be compromised by physical and psychological illnesses [8][9][10][11]. In patients with breast cancer, deficits in working memory and selective attention were found throughout the cancer trajectory, from presurgery, during, and after treatment [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. Across multiple cross-sectional [13][14][15]27] and longitudinal [12,18,26] studies, demographic and clinical characteristics associated with worse CRCI included younger age [14,15,26], lower annual income [26], higher comorbidity burden [18,26], lower functional status [26], higher symptom distress [13,14], and higher total mood disturbance [13,14].…”