Cognitive rehabilitation group intervention for breast cancer survivors: results of a randomized clinical trial

Ercoli, Linda M.; Petersen, Laura; Hunter, Aimee M.; Castellon, Steven A.; Kwan, Lorna; Kahn-Mills, Barbara A.; Embree, L. M.; Cernin, Paul A.; Leuchter, Andrew F.; Ganz, Patricia A.

doi:10.1002/pon.3769

Cited by 93 publications

(84 citation statements)

References 31 publications

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“…[7] Another implication of the results is that routine cognitive assessment of older survivors undergoing hormonal therapy might be used to identify those in need of interventions like medication reminders or supportive care, or to identify those who might be considered for alternative regimens with fewer cognitive side effects. If any medication-induced cognitive changes are identified, promising evidence suggests that compensatory cognitive rehabilitation strategies [51, 52] may be effective in improving cognitive function and potentially promoting treatment adherence. Additionally, interventions that include physical activity can mitigate cognitive impairment and other treatment side effects, [53] and could be examined as methods to enhance hormonal therapy completion.…”

Section: Discussionmentioning

confidence: 99%

Cognitive function and discontinuation of adjuvant hormonal therapy in older breast cancer survivors: CALGB 369901 (Alliance)

Bluethmann

Alfano

Clapp

et al. 2017

Breast Cancer Res Treat

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Purpose To investigate the effects of cognitive function on discontinuation of hormonal therapy in breast cancer survivors ages 65+ (“older”). Methods Older breast cancer survivors with invasive, non-metastatic disease and no reported cognitive difficulties were recruited from 78 Alliance sites between 2004–2011. Eligible survivors (n=1280) completed baseline interviews; follow-up was conducted annually for up to seven years. Survivors with estrogen-receptor positive (ER+) cancers who initiated hormonal therapy (n=990) were included. Self-reported cognitive function was measured using the EORTCQLQ30 scale; a difference of 8 points on the 0–100 scale was considered clinically significant. Based on varying rates of discontinuation over time, discontinuation was evaluated separately for three time-periods: early (<1 year); midpoint (1–3 years); and late discontinuation (>3–5 years). Cox models for each time-period were used to evaluate the effects of cognition immediately preceding discontinuation, controlling for age, chemotherapy, and other covariates. Results Survivors were 65–91 years old (mean 72.6 years), and 79% had stages 1 or 2A disease. Overall, 43% discontinued hormonal therapy before five years. Survivors who reported lower cognitive function in the period before discontinuation had greater hazards of discontinuing therapy at the treatment midpoint (HR 1.22 per 8-point difference, CI 1.09–1.40, p<.001), considering covariates, but cognition was not related to discontinuation in the other periods. Conclusions Self-reported cognitive problems were a significant risk factor for discontinuation of hormonal therapy 1–3 years post-initiation. Additional research is needed on the temporality of cognitive effects and hormonal therapy to support survivorship care needs of older survivors.

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Section: Discussionmentioning

confidence: 99%

Cognitive function and discontinuation of adjuvant hormonal therapy in older breast cancer survivors: CALGB 369901 (Alliance)

Bluethmann

Alfano

Clapp

et al. 2017

Breast Cancer Res Treat

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“…The premise of restoration-based methods is that through repetitive practice of cognitive retraining activities, overall cognitive performance will improve [21]. Recent clinical studies evaluating the use of restoration-based methods with cancer survivors, including breast cancer survivors, has found that these methods can improve cognitive function [22,23]. Unfortunately, these studies and several others suggest that this restoration approach has little impact on everyday life performance [22–26].…”

Section: Introductionmentioning

confidence: 99%

The Feasibility of Using Metacognitive Strategy Training to Improve Cognitive Performance and Neural Connectivity in Women with Chemotherapy-Induced Cognitive Impairment

Wolf

Doherty²,

Kallogjeri³

et al. 2016

Oncology

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Objective: To evaluate the feasibility and preliminary effect of metacognitive strategy training (MCST) on cognitive performance and on neural connectivity in the frontoparietal network in women with chemotherapy-induced cognitive impairment (CICI) following treatment for breast cancer. Methods: A single-group pre/post study was conducted. After completing the baseline assessment battery and neuroimaging, the participants completed a 12-session MCST intervention. Following the completion of the intervention, the subjects completed the same assessment battery and neuroimaging as was completed at baseline within 4 weeks after the intervention. The key inclusion/exclusion criteria for this study were: completed chemotherapy for treatment of breast cancer, no other neurological or psychiatric diagnoses, self-reported CICI, and no contraindications to the use of MRI. Results: MCST had a small-to-large positive effect on all primary (cognitive) and secondary (quality of life and psychosocial) behavioral outcome measures (r = -0.12 to -0.88). There was also a positive change in functional connectivity in a frontoparietal cognitive control network connection in 6 of the 10 subjects, which was correlated to changes in the behavioral measures. Conclusions: This study found that MCST was associated with a positive effect on cognitive performance and neural connectivity in women with CICI following treatment for breast cancer.

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“…Since complaints are inextricably tied to mood and psychological processes, they can signal coincident mood symptoms. Effective intervention approaches may include cognitive rehabilitation [19], and Cognitive Behavioral Therapy [35] such as addressing harmful or negative thought patterns, and cognitive complaints may be the best measures to assess intervention efficacy.…”

Section: Discussionmentioning

confidence: 99%

“…The Cognitive Rehabilitation Study sample (n=72) consisted of female breast cancer survivors with persistent cognitive complaints following primary treatment for cancer recruited for two separate clinical trials of a cognitive remediation protocol [18, 19]. Baseline data were used in the current study.…”

Section: Methodsmentioning

confidence: 99%

Measuring cognitive complaints in breast cancer survivors: psychometric properties of the patient’s assessment of own functioning inventory

Dyk

Ganz

Ercoli

et al. 2016

Support Care Cancer

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Purpose Cognitive complaints are a concern for breast cancer survivors. Among various published measures for cognitive complaints, the Patient’s Assessment of Own Functioning Inventory (PAOFI) is one of the few assessing a spectrum of cognitive abilities, including those most commonly reported by breast cancer survivors. This study aimed to examine the psychometric properties of the PAOFI in breast cancer survivors. Methods An exploratory factor analysis was conducted with a sample of breast cancer survivors (n=189) who had completed all primary cancer treatments. Construct validity was examined by correlating factor scores with valid measures of cognitive complaints, fatigue, and quality of life. Reliability was measured by internal consistency of the items in each factor within this sample, a separate sample of breast cancer survivors with high persistent cognitive complaints (n=72), and healthy controls (n=63). Factor scores were compared across the three samples. Results A five-factor structure similar to the PAOFI standardization study was found, with factors related to executive functioning (accounting for most of the variance), two aspects of memory functioning, language, motor/sensory-perceptual abilities. Factor scores highly correlated with measures of cognitive complaints, fatigue, and quality of life. Executive functioning and memory-related factors achieved adequate reliability across samples. Scores were significantly different across the three samples as expected. Conclusions The PAOFI is a reliable and valid tool for measuring cognitive complaints in breast cancer survivors.

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Cognitive rehabilitation group intervention for breast cancer survivors: results of a randomized clinical trial

Cited by 93 publications

References 31 publications

Cognitive function and discontinuation of adjuvant hormonal therapy in older breast cancer survivors: CALGB 369901 (Alliance)

Cognitive function and discontinuation of adjuvant hormonal therapy in older breast cancer survivors: CALGB 369901 (Alliance)

The Feasibility of Using Metacognitive Strategy Training to Improve Cognitive Performance and Neural Connectivity in Women with Chemotherapy-Induced Cognitive Impairment

Measuring cognitive complaints in breast cancer survivors: psychometric properties of the patient’s assessment of own functioning inventory

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