Cognitive functioning and its associated factors among breast cancer patients on chemotherapy at Tikur Anbessa specialized hospital, Addis Ababa Ethiopia: an institution-based comparative cross-sectional study

Abstract

Background Breast cancer is the second leading cause of cancer in the world. It is the commonest type of cancer in Ethiopia. Cognitive problems are common among breast cancer patients. The study aimed to assess cognitive functioning and its associated factors among breast cancer patients at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia 2020. Methods Institution-based comparative cross-sectional study was conducted. Study subjects were 117 breast cancer patients on chemotherapy and 117 women without breast cancer who volunteered for the study. Data was collected from May–June 2020. The Mini-mental status exam (MMSE) was used to assess cognitive functioning. Data were entered into Epi Data version 4.6.0.2 and analyzed using STATA version 14 software. Univariable and multivariable linear regression model was fitted to identify factors associated with cognitive functioning. A two-tailed p-value less than 0.05 was used to declare statistical significance. Results Among the total breast cancer patients 41.9% were diagnosed with earlier sage of the diseases (stage I and II), while the rest 58.1% were diagnosed with stage III and stage IV breast cancer. A significant difference in the MMSE score was observed among breast cancer patients and controls (19.76 ± 5.29, 25.18 ± 4.68 p < 0.0001) respectively. In multivariable linear regression analysis being non-breast cancer (Adjusted beta coefficient (Adj.β.coff). = 3.34, 95% CI (1.92–4.76) p < 0.001), hemoglobin gm/dl (Adj.β.coff =0.34, 95% CI (0.04–0.63) p = 0.02), and primary education (Adj.β.coff =2.98 95%CI (1.16–4.96) p = 0.001) secondary level and more education (Adj.β.coff = 5.47, 95%CI (3.51–7.28) p < 0.001) were significantly associated with MMSE cognitive score. Conclusion Breast cancer patients had lower mean MMSE scores when compared to non-breast cancer women. Higher hemoglobin level and higher level of education increase the MMSE cognitive score. Clinicians should incorporate routine screening of cognitive functioning for breast cancer patients and further study is required to evaluate cognitive impairment among breast cancer patients in Ethiopia.

Cognitive impairments associated with chemotherapy in women with breast cancer: a meta-analysis and meta-regression

“…Thus, women with breast cancer who have lower education levels seem to have worse cognitive performance. These data corroborated the findings of a previous study that found an association between lower education level and worse Mini-Mental State Examination (MMSE) performance in women with breast cancer ( 38 ).…”

“…Information on participants' menopausal status was presented in 10 (50%) of the studies. Supplementary Table S2 presents information about the articles included in this review ( 6 , 23 - 36 , 38 - 41 , 46 ).…”

“…The analysis was performed with nine studies composed of women under 50 years of age, totaling 343 women in the clinical group and 341 controls ( 28 , 30 - 32 , 34 , 38 - 41 ). The results indicated that women younger than 50 years who received chemotherapy performed lower on tests that assessed general cognition compared to the control group (-1.15 [95%CI: -1.63 to -0.67], P<0.01) ( Figure 3 ).…”

The Managing Cancer and Living Meaningfully (CALM) Intervention Alleviates Chemotherapy-Related Cognitive Impairment in Patients with Breast Cancer by Modulating Pan-Immune-Inflammation Values

“… 22 The MMSE is graded on a 30-point scale. 23 Abebe et al 24 assessed cognitive function in patients with BC. The MMSE has been widely applied in cognitive studies of Chinese patients 25 - 27 and its reliability and validity have been verified previously.…”

Imagens de tensores de difusão em mulheres com queixas cognitivas persistentes após quimioterapia para câncer de mama

“…Como exemplo, encontramos apenas 2 publicações com estudos sobre o CRCI em pacientes com câncer de mama realizadas do continente africano. (126,127)…”