Randomized controlled trial of increasing physical activity on objectively measured and self‐reported cognitive functioning among breast cancer survivors: The memory & motion study

Abstract

BACKGROUND: Increasing physical activity can improve cognition in healthy and cognitively impaired adults; however, the benefits for cancer survivors are unknown. The current study examined a 12-week physical activity intervention, compared with a control condition, on objective and self-reported cognition among breast cancer survivors. METHODS: Sedentary breast cancer survivors were randomized to an exercise arm (n 5 43) or a control arm (n 5 44). At baseline and at 12 weeks, objective cognition was measured with the National Institutes of Health Cognitive Toolbox, and self-reported cognition using the Patient-Reported Outcomes Measurement Information System scales. Linear mixed-effects regression models tested intervention effects for changes in cognition scores. RESULTS: On average, participants (n 5 87) were aged 57 years (standard deviation, 10.4 years) and were 2.5 years (standard deviation, 1.3 years) post surgery. Scores on the Oral Symbol Digit subscale (a measure of processing speed) evidenced differential improvement in the exercise arm versus the control arm (b 5 2.01; P <.05). The between-group differences in improvement on selfreported cognition were not statistically significant but were suggestive of potential group differences. Time since surgery moderated the correlation, and participants who were 2 years post surgery had a significantly greater improvement in Oral Symbol Digit score (exercise vs control (b 5 4.00; P <.01), but no significant improvement was observed in patients who were >2 years postsurgery (b 5 21.19; P 5.40). A significant dose response was observed with greater increased physical activity associated with objective and self-reported cognition in the exercise arm. CONCLUSIONS: The exercise intervention significantly improved processing speed, but only among those who had been diagnosed with breast cancer within the past 2 years. Slowed processing speed can have substantial implications for independent functioning, supporting the potential importance of early implementation of an exercise intervention among patients with breast cancer.

The effects of weight loss and metformin on cognition among breast cancer survivors: Evidence from the Reach for Health study

“…The meta‐analysis showed benefits of intentional weight loss across multiple cognitive domains; however, most of the studies had small sample sizes (total seven studies N = 468), enrolled healthy participants, and had a lower mean age (54 years old) than the current study, and five out of the seven studies had a shorter intervention duration. Many of the RCTs in the meta‐analysis also achieved much greater weight loss than the current study, and some had more intensive exercise components in their interventions, which may also independently influence cognition . These differences in populations, amount of weight loss achieved, and differences in exercise prescriptions across interventions are all possible reasons why findings from the current study may contrast with previous reports.…”

A randomized controlled trial of WATAAP to promote physical activity in colorectal and endometrial cancer survivors

“…The considerable increase of 45 min/wk of MVPA observed in our intervention is almost double that of most previous studies and may be because of the evidence‐based BCTs that are now incorporated into smart‐tracker technology including self‐monitoring, goal setting, and behavioural feedback. A recent higher‐intensity Fitbit intervention with breast cancer survivors supports this finding, demonstrating a 103 min/wk net improvement in MVPA . Fitbit engagement was high throughout the intervention (86%) displaying promise for low‐intensity interventions.…”

“…Reviews of trials incorporating wearables support the effectiveness of trackers for increasing PA and reducing sedentary behaviour . There is evidence to support the effectiveness of wearables for increasing PA among adults with chronic disease, postmenopausal women, and in breast cancer survivors . Research on “smart” wearables in survivors has thus far been limited to predominantly breast survivors and has not involved group sessions as components of the intervention.…”

“…21 There is evidence to support the effectiveness of wearables for increasing PA among adults with chronic disease, 22 postmenopausal women, 23 and in breast cancer survivors. 24,25 Research on "smart" wearables in survivors has thus far been limited to predominantly breast survivors and has not involved group sessions as components of the intervention. Our trial is novel because it includes group sessions and relational support 26 and the inclusion of BCTs (eg, action planning) that are absent from wearables and their Apps.…”

Physical Activity, Exercise and Breast Cancer - What Is the Evidence for Rehabilitation, Aftercare, and Survival A Review

“…Cancer-Related Cognitive Impairment A systematic review with 19 studies (rodents and humans) presented that physical activity such Asian-influenced movement programs could have a positive influence on self-perceived cognitive functions in patients with breast cancer in aftercare; it may also reduce chronic inflammation [36]. The review suggests that exercise interventions can help in the prevention and rehabilitation of CRCI and improve processing speed with early implementation (diagnosis <2 years) among breast cancer patients [37]. However, the evidence and quality of the studies in humans are poor.…”