Determinants of the Higher Prevalence and Severity of Subjective Cognitive Impairment in Cancer Patients Compared to Healthy Subjects: Fatigue and Stress

Kim, Hee-Ju; Abraham, Ivo

doi:10.1177/1054773820957474

Cited by 6 publications

(6 citation statements)

References 42 publications

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“…Although this study aimed not to examine the effect of the individual indicator variables, global stress was the variable within the patient-specific factors’ latent variable that had the largest association with CRCI (Appendix A, http://links.lww.com/NRES/A468). This finding is consistent with previous research that found that higher levels of perceived stress were an independent predictor for self-reported CRCI (Kim & Abraham, 2021). In addition, this finding supports the need to evaluate various types of stress as risk factors for CRCI.…”

Section: Discussionsupporting

confidence: 93%

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An Evaluation of the Multifactorial Model of Cancer-Related Cognitive Impairment

Oppegaard

Mayo

Armstrong³

et al. 2023

Nursing Research

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BackgroundUp to 45% of patients report cancer-related cognitive impairment (CRCI). A variety of characteristics are associated with the occurrence and/or severity of CRCI. However, an important gap in knowledge of risk factors for CRCI is the relative contribution of each factor. The multifactorial model of cancer-related cognitive impairment (MMCRCI) is a conceptual model of CRCI that can be used to evaluate the strength of relationships between various factors and CRCI.ObjectivesThe purpose of this study was to use structural regression methods to evaluate the MMCRCI using data from a large sample of outpatients receiving chemotherapy (n = 1,343). Specifically, the relationships between self-reported CRCI and four MMCRCI concepts (i.e., social determinants of health, patient-specific factors, treatment factors, and co-occurring symptoms) were examined. The goals were to determine how well the four concepts predicted CRCI and determine the relative contribution of each concept to deficits in perceived cognitive function.MethodsThis study is part of a larger, longitudinal study that evaluated the symptom experience of oncology outpatients receiving chemotherapy. Adult patients were diagnosed with breast, gastrointestinal, gynecological, or lung cancer; had received chemotherapy within the preceding 4 weeks; were scheduled to receive at least two additional cycles of chemotherapy; were able to read, write, and understand English; and gave written informed consent. Self-reported CRCI was assessed using the attentional function index. Available study data were used to define the latent variables.ResultsOn average, patients were 57 years of age, college educated, and with a mean Karnofsky Performance Status score of 80. Of the four concepts evaluated, whereas co-occurring symptoms explained the largest amount of variance in CRCI, treatment factors explained the smallest amount of variance. A simultaneous structural regression model that estimated the joint effect of the four exogenous latent variables on the CRCI latent variable was not significant.DiscussionThese findings suggest that testing individual components of the MMCRCI may provide useful information on the relationships among various risk factors, as well as refinements of the model. In terms of risk factors for CRCI, co-occurring symptoms may be more significant than treatment factors, patient-specific factors, and/or social determinants of health in patients receiving chemotherapy.

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Section: Discussionsupporting

confidence: 93%

“…with previous research that found that higher levels of perceived stress were an independent predictor for self-reported CRCI (Kim & Abraham, 2021). In addition, this finding supports the need to evaluate various types of stress as risk factors for CRCI.…”

Section: Discussionsupporting

confidence: 86%

An Evaluation of the Multifactorial Model of Cancer-Related Cognitive Impairment

Oppegaard

Mayo

Armstrong³

et al. 2023

Nursing Research

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“…In our study, we observed a high probability of fatigue in both the high (0.88) and moderate (0.99) symptom-burden classes, thus estimating it to be common among individuals with subjective cognitive decline in South Korea. Thus, as fatigue was a common symptom in this group and as there was an association between fatigue and subjective cognitive decline, our findings are consistent with previous studies 40 42. Therefore, we posit that fatigue is a predominant symptom among individuals with subjective cognitive decline, and therefore, further studies should determine the prevalence of fatigue in subjective cognitive decline and its associations in different populations.…”

Section: Discussionsupporting

confidence: 91%

“…Fatigue is a common symptom among patients suffering from varied diseases, such as cancer, multiple sclerosis and stroke, wherein, fatigue is strongly associated with experiences of subjective cognitive decline. 40–42 These findings suggest that fatigue is not only a common symptom in individuals with subjective cognitive decline but could also act as an influencing factor. In addition, 43 reported that individuals’ perception of their cognitive function is more reflective of their emotional state and fatigue than their objective abilities.…”

Section: Discussionmentioning

confidence: 95%

Symptom profiles and their influencing factors among people with subjective cognitive decline: a secondary analysis of cross-sectional data from the 2019 Korea Community Health Survey using latent class analysis

Seong,

Park

2023

BMJ Open

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ObjectiveSubjective cognitive decline, self-perceived cognitive deterioration without objective impairment, is becoming a vital health indicator, especially due to its intermediate stage between normal function and mild cognitive impairment. Cognitive decline often coexists with various symptoms that may interact with each other, serve as prognostic indicators and influence the progression of cognitive decline. This study aims to identify symptom clusters among individuals with subjective cognitive decline, using latent class analysis, and to identify factors affecting these symptom clusters, offering insights into understanding and potentially preventing cognitive decline progression.Design and settingA secondary data analysis of the nationally representative cross-sectional data obtained from the 2019 Korea Community Health Survey.OutcomesWe performed latent class analysis using six symptoms (pain, sleep deprivation, depression, fatigue, restlessness and apathy) to determine the distinct symptom clusters. After selecting the best latent class model, we identified factors influencing those symptom clusters using multinomial logistic regression analyses.ResultsWe found that a three-latent-class model best fitted the data: a low symptom-burden group (39.9%), a moderate symptom-burden group (44.8%) and a high symptom-burden group (15.3%). Male gender, higher age, higher perceived health status and lower perceived stress status, were strongly associated with lesser odds of being in the moderate (OR: 0.37 (95% CI: 0.33 to 0.41)) to OR: 2.20 (95% CI: 2.03 to 2.39)) and high symptom-burden groups (OR: 0.18 (95% CI: 0.15 to 0.21)) to OR: 8.53 (95% CI: 7.68 to 9.49)) as compared with being in the low symptom-burden group.ConclusionFindings may contribute to improving clinical practitioners’ understanding of the unique symptom patterns experienced by people with subjective cognitive decline and their influencing factors. Furthermore, we recommend that formal caregivers screen and manage prevalent symptoms considering the factors affecting the symptoms of people with subjective cognitive decline in clinical practice.

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“…5,6 Sleep disturbance refers to an abnormality in the sleep process or the occurrence of abnormal behaviors during sleep, such as insomnia, poor sleep quality, sleep disorders, memory decline, emotional disorders, and waking up easily at night. 7 Patients with cancer who experience sleep disturbance are more likely to develop infections, 8 physical fatigue, psychological distress, cognitive impairment, and low quality of life [9][10][11] ; mortality is also higher in these patients. 11 Although healthcare practitioners often administer benzodiazepines for sleep disturbance, these pharmacological agents have side effects such as drug dependence, impaired cognitive attention, and suicidal tendencies.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of mind‐body therapies for sleep disturbance in patients with early‐stage cancer: A systematic review and network meta‐analysis

Han

Shi

et al. 2023

Psycho-Oncology

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ObjectiveTo evaluate and compare the efficacy of different mind‐body therapies (MBTs) for sleep disturbance in patients with early‐stage cancer.MethodsRandomised controlled trials that included patients (aged ≥18 years) with early stage cancer who underwent MBTs (mindfulness, hypnosis, relaxation, yoga, and qigong) were searched in the CINAHL via the EBSCO Host, Cochrane Library, Embase, MEDLINE, PsycINFO, PubMed, and Scopus databases, from the date of database inception to October 2022. The outcomes were subjective sleep disturbance and objective sleep efficiency. Network meta‐analysis (NMA) and comparative effects ranking were performed using STATA (v14.0; STATACorp, College Station, TX, USA).ResultsForty‐seven studies investigating five MBTs were included in the NMA. For cancer patients receiving active treatment, mindfulness demonstrated the largest effect size in reducing subjective sleep disturbance (standardised mean difference [SMD]: 0.85; 95% confidence intervals [CI]: 0.20–1.50; Grading of Recommendations Assessment, Development, and Evaluation assessment: moderate), and had the highest cumulative probability compared to usual care or waitlist. For cancer patients who had completed active treatment, qigong demonstrated the largest effect size in reducing subjective sleep disturbance (SMD: 0.99; 95% CI: 0.35–1.63; GRADE: low), followed by hypnosis (SMD: 0.87; 95% CI: 0.32–1.42; GRADE: moderate), and mindfulness (SMD: 0.42; 95% CI: 0.24–0.59; GRADE: moderate). Qigong also demonstrated the largest effect size in improving objective sleep efficiency (weighted mean differences: 10.76; 95% CI: 2.01–19.50; GRADE: low); however, the effect of qigong was tested in only one study in this NMA. Among the eight different treatment conditions, cognitive behavioral therapy (CBT) showed the highest cumulative probability (surface under the cumulative ranking curve: 96.3%) in reducing subjective sleep disturbance and the second highest cumulative probability (SUCRA: 83.3%) in improving objective sleep efficiency.ConclusionThere is no evidence supporting the use of MBTs to replace or be comparable to CBT. Mindfulness can be recommended as an optional treatment for reducing sleep disturbance in patients with early‐stage cancer. Some support was observed for qigong and hypnosis in reducing sleep disturbances in patients with early‐stage cancer who had completed active treatment. More rigorous trials are warranted to confirm whether different forms of MBTs have different effects on sleep in patients with cancer.

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Determinants of the Higher Prevalence and Severity of Subjective Cognitive Impairment in Cancer Patients Compared to Healthy Subjects: Fatigue and Stress

Cited by 6 publications

References 42 publications

An Evaluation of the Multifactorial Model of Cancer-Related Cognitive Impairment

An Evaluation of the Multifactorial Model of Cancer-Related Cognitive Impairment

Symptom profiles and their influencing factors among people with subjective cognitive decline: a secondary analysis of cross-sectional data from the 2019 Korea Community Health Survey using latent class analysis

Efficacy of mind‐body therapies for sleep disturbance in patients with early‐stage cancer: A systematic review and network meta‐analysis

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