Cognitive Functioning and Health in Hispanic/Latina Breast Cancer Survivors

Neurocognitive test performance following cancer among middle‐aged and older adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the SOL‐Investigation of Neurocognitive Aging Ancillary Study

“…To our knowledge, this is the first study to examine the association between a history of cancer and neurocognitive test performance among Hispanic/Latino adults. Studies of cognitive function among Hispanics/Latinos are limited, 14 but are needed given that Hispanics/Latinos are often diagnosed with cancer at younger ages than other racial/ethnic groups, 16 which may alter the trajectory of cognitive decline over a longer period of time, and Hispanics/Latinos are diagnosed with cancer at more advanced stage, 17 which may require more aggressive, systemic, and potentially neurotoxic therapies resulting in worse cognitive impairment. One recent study of 54 Hispanic/Latina breast cancer survivors examined associations of body composition, diet, and physical activity with cognitive function, 14 but was limited by a cross-sectional design, and was not aimed at examining the effects of cancer on cognition.…”

“…Studies of cognitive function among Hispanics/Latinos are limited, 14 but are needed given that Hispanics/Latinos are often diagnosed with cancer at younger ages than other racial/ethnic groups, 16 which may alter the trajectory of cognitive decline over a longer period of time, and Hispanics/Latinos are diagnosed with cancer at more advanced stage, 17 which may require more aggressive, systemic, and potentially neurotoxic therapies resulting in worse cognitive impairment. One recent study of 54 Hispanic/Latina breast cancer survivors examined associations of body composition, diet, and physical activity with cognitive function, 14 but was limited by a cross‐sectional design, and was not aimed at examining the effects of cancer on cognition. 14 As summarized in a number of systematic reviews and meta‐analyses of studies of CRCI, most of which have focused on non‐Hispanics/Latinos diagnosed with breast 34 , 35 or prostate 36 , 37 cancers, studies have consistently reported greater cognitive dysfunction and greater declines in cognitive function among patients treated with systemic therapies as compared to normative samples, study control groups, or pre‐treatment baseline assessments of the same cancer patients.…”

“…One recent study of 54 Hispanic/Latina breast cancer survivors examined associations of body composition, diet, and physical activity with cognitive function, 14 but was limited by a cross‐sectional design, and was not aimed at examining the effects of cancer on cognition. 14 As summarized in a number of systematic reviews and meta‐analyses of studies of CRCI, most of which have focused on non‐Hispanics/Latinos diagnosed with breast 34 , 35 or prostate 36 , 37 cancers, studies have consistently reported greater cognitive dysfunction and greater declines in cognitive function among patients treated with systemic therapies as compared to normative samples, study control groups, or pre‐treatment baseline assessments of the same cancer patients. Studies examining CRCI among women with cervical cancer or cervical cancer survivors are limited, but our findings are consistent with prior studies including a cross‐sectional study by Areklett and colleagues 38 of 254 cervical cancer survivors in Norway who were treated with combined chemo‐radiotherapy or surgery only, and a longitudinal study by Kirchheiner and colleagues 39 of 744 EMBRACE Study participants with locally advanced cervical cancer who underwent definitive chemoradiation therapy with image guided adaptive brachytherapy.…”

“…Epidemiologic studies of cognitive function following cancer conducted to date have primarily focused on affluent, highly educated, non‐Hispanic White populations, 2 and have reported increases in acute cognitive impairments following cancer 10–13 . Studies of Hispanics/Latinos are limited to just one cross‐sectional study that examined correlates of cognitive functioning among Hispanic/Latina breast cancer survivors 14 . However, the effects of cancer therapies on cognition may be of particular relevance for Hispanics/Latinos who are the second largest racial or ethnic group in the United States accounting for 19% of the total population, 15 and who are often diagnosed with cancer at younger ages 16 and at later stages requiring more aggressive and systemic treatments compared to non‐Hispanic Whites 17…”

“…[10][11][12][13] Studies of Hispanics/ Latinos are limited to just one cross-sectional study that examined correlates of cognitive functioning among Hispanic/Latina breast cancer survivors. 14 However, the effects of cancer therapies on cognition may be of particular relevance for Hispanics/Latinos who are the second largest racial or ethnic group in the United States accounting for 19% of the total population, 15 and who are often diagnosed with cancer at younger ages 16 and at later stages requiring more aggressive and systemic treatments compared to non-Hispanic Whites. 17 To address these knowledge gaps, this study examined the associations between a history of cancer with neurocognitive test performance and with a 7-year change in neurocognitive test performance among diverse middleaged and older Hispanic/Latino adults enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).…”