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 especially if they are treated with chemotherapy. The study aimed to assess cognitive functioning and its associated factors among breast cancer patients at Tikur Anbessa Specialized Hospital, 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 was used to assess cognitive functioning. Data was entered into Epi Data version 4.6.0.2 and analyzed using STATA software version 14. Univariable and multivariable linear regression model was fitted to identify factors associated with cognitive functioning. A two-tailed p-value lower than 0.05 was used to declare statistical significance.Results: 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 (controls) (std.β 3.34, 95% CI [1.92 4.76] p<0.001), hemoglobin gm/dl (std. β 0.34, 95 % CI [0.04 0.63] p=0.02), and primary education (Adj. β 2.98 95 %CI [1.16 4.96] p=0.001) secondary level and more education (std. β 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 controls. Hemoglobin level, breast cancer status, and educational level are significant predictors of 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.