Potential factors associated with perceived cognitive impairment in breast cancer survivors

Abstract

Purpose This cross-sectional study was designed to explore potential factors associated with perceived cognitive impairment (PCI) in breast cancer survivors compared to controls and gain insight into perceived levels of severity for cognitive complaints. Methods Women (N=363, 317: breast cancer, 46: healthy controls) completed demographic questionnaire, MD Anderson Symptom Inventory, Attentional Function Index, and Functional Assessment for Cancer Therapy-Cognition. Group classification included pre-chemotherapy, current chemotherapy, and postchemotherapy (≤1, >1–≤2, >2–≤5, >5 years). Results A significant group effect was seen for PCI (F6, 355= 7.01, p<0.0001). Controls reported less PCI than all other groups. Neuropathy was inversely correlated with PCI (r= −0.23; p<0.0001) for participants with breast cancer. A significant association was demonstrated between exercise frequency and PCI in women exposed to chemotherapy (F3, 135= 3.78, p<0.05). A multiple linear regression model built using forward selection methods explained 24 % of the variance (adjusted R2) for PCI in breast cancer participants and included group, body mass index (BMI), exercise, fatigue, and distress. Exercise frequency moderated the relationship between BMI and PCI for breast cancer participants (F3, 198=2.4, p= 0.07) and reduced the negative effects of high BMI. The moderating effect of exercise was significant (F3, 133=3.1, p=0.03) when limited to participants exposed to chemotherapy. Conclusions PCI decreased for women >5 years postchemotherapy. Overweight survivors who exercised frequently reported less PCI than sedentary survivors. Study results provide support for a relationship between BMI and PCI in breast cancer survivors and exercise as a potential intervention for cognitive complaints. Further investigation of the influence of weight and exercise on cognitive function is warranted.

Perceived cognitive function for breast cancer survivors: association of genetic and behaviorally related variables for inflammation

“…We conducted an exploratory candidate gene substudy participants who took part in a larger cross-sectional parent study [2]. The parent study was designed to investigate potential predictors of perceived cognitive impairment for women with breast cancer and included 363 participants (317 women with breast cancer and 46 controls).…”

“…PCF is an individual’s perception of their cognitive ability and is subjectively assessed through patients’ self-report. Our own work demonstrated a negative association between BMI and PCF that was reduced by higher exercise frequency [2]. However, to our knowledge, no studies have been conducted to investigate the relationships between genetic variability for inflammation, behaviorally-related variables (such as BMI and exercise patterns), and PCF for breast cancer survivors.…”

“…Variability exists in the severity and duration of poorer cognitive function prior to adjuvant therapy and deterioration in cognitive function during and after treatment for breast cancer [1]. Genetic and behaviorally-related factors for inflammation may influence this variability in cognitive function [1,2]. Research is needed to identify women who may be at increased risk for declines in cognitive function and, ultimately, to design appropriate interventions to prevent or mitigate the impact of cancer and cancer treatment on cognitive function.…”

Characteristics associated with inter-individual differences in the trajectories of self-reported attentional function in oncology outpatients receiving chemotherapy

“…Supplementary Table 1 lists the potential demographic, clinical, and symptom predictors that were developed based on a review of the literature on factors associated with changes in attentional function and cognitive in oncology patients undergoing CTX (for reviews see 10, 29–31). …”

“…The AFI was developed by Cimprich and colleagues to evaluate changes in executive function in women undergoing breast cancer surgery [5]. More recently, changes in attentional function were evaluated in patients with breast and prostate cancer undergoing radiation therapy [6,7]; in patients who were followed for 6 months after breast cancer surgery [8]; and in cancer survivors [9,10]. However, no studies were found that evaluated for changes in self-reported attentional function in patients receiving multiple cycles of CTX.…”