The impact of APOE and smoking history on cognitive function in older, long-term breast cancer survivors

Ahles, Tim A.; Orlow, Irene; Schofield, Elizabeth; Li, Yuelin; Ryan, Elizabeth; Root, James C.; Patel, Sunita K.; McNeal, Katrazyna; Gaynor, Alexandra M.; Tan, Heidi; Katheria, Vani; Vázquez, Jessica; Corrales–Guerrero, Sergio; Sadeghi, Keimya; Traina, Tiffany A.; Hurria, Arti

doi:10.1007/s11764-022-01267-z

Cited by 4 publications

(10 citation statements)

References 54 publications

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“…Interestingly, the parent study from which the present neuroimaging substudy derived showed worse performance on all three domains of cognitive function, including language, executive function, and learning and memory, over time in the cancer survivors with or without chemotherapy but not in the non‐cancer controls. Similar to the FA data, the parent study found no significant differences in cognitive testing scores between the two cancer survivor groups 31 . Taken together, the FA values in the genu of the corpus callosum and the cognitive functioning of the three domains could potentially serve as markers for CRCI in older breast cancer survivors.…”

Section: Discussionsupporting

confidence: 64%

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Brain white matter microstructural changes in chemotherapy‐treated older long‐term breast cancer survivors

Daniel,

Deng,

Patel

et al. 2023

Cancer Medicine

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PurposeTo assess white matter microstructural changes in older long‐term breast cancer survivors 5–15 years post‐chemotherapy treatment.MethodsBreast cancer survivors aged 65 years or older who underwent chemotherapy (C+) and who did not undergo chemotherapy (C−) and age‐ and sex‐matched healthy controls (HC) were enrolled at time point 1 (TP1) and followed for 2 years for time point 2 (TP2). All participants underwent brain MRI with diffusion tensor images and neuropsychological (NP) testing with the NIH Toolbox Cognition Battery. Tract‐based spatial statistics (TBSS) analysis was performed on the diffusion tensor images to assess white matter microstructural changes with the fractional anisotropy (FA) parameter.ResultsThere were significant longitudinal alterations in FA within the C+ group over time. The C+ group showed diminished FA in the body and genu of corpus callosum, anterior corona radiate, and external capsule on both the whole brain and region of interest (ROI) based analyses after p < 0.05 family‐wise error (FWE) correction. However, there were no significant group differences between the groups at TP1. Additionally, at TP1, a positive correlation (R = 0.58, p = 0.04) was observed between the FA value of the anterior corona radiata and the crystallized composite score in the C+ group.ConclusionsBrain white matter microstructural alterations may be the underlying neural correlates of cognitive changes in older breast cancer survivors who had chemotherapy treatment years ago.

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Section: Discussionsupporting

confidence: 64%

“…Similar to the FA data, the parent study found no significant differences in cognitive testing scores between the two cancer survivor groups. 31 Taken together, the FA values in the genu of the corpus callosum and the cognitive functioning of the three domains could potentially serve as markers for CRCI in older breast cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

Brain white matter microstructural changes in chemotherapy‐treated older long‐term breast cancer survivors

Daniel,

Deng,

Patel

et al. 2023

Cancer Medicine

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“…While we note that generational cohort effects are of less concern given evidence that these effects have diminished, we cannot rule out any cohort effect on our analysis as a whole. As an example, tobacco use has steadily declined in successive generations and previous nicotine exposure has been associated with a potentially protective effect on cognition in APOE4+ carriers [ 35 ]. With the addition of control data from equivalent ages/cohorts, we can, however, control for any cohort effects that would influence differences in cognition between survivors and controls.…”

Section: Discussionmentioning

confidence: 99%

“…The data reported here were collected as part of a collaboration between Memorial Sloan Kettering Cancer Center and City of Hope (PIs: Ahles; Hurria) on a cohort study that assessed cognition in controls and breast cancer survivors (age 60 or greater) who were all at least five years post-treatment and were followed prospectively over two years with four timepoints at eight-month intervals [ 35 ]. In this secondary analysis, we examined data derived from the first time-point across a longer 5–15-year interval, in four quartiles, as a proxy indicator of how cognitive trajectories might be altered given a history of cancer and cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Aging in Older Breast Cancer Survivors

Root

Schofield

et al. 2023

Cancers

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Background: Cancer and cancer treatments may affect aging processes, altering the trajectory of cognitive aging, but the extant studies are limited in their intervals of assessment (two–five years). We studied the cognitive performance of a cohort of survivors and controls aged from 60 to 89 years utilizing cross-sectional cognitive performance data as an indicator of potential aging trajectories and contrasted these trends with longitudinal data collected over two years. Methods: Female breast cancer survivors who had been diagnosed and treated at age 60 or older and were 5- to 15-year survivors (N = 328) and non-cancer controls (N = 158) were assessed at enrollment and at 8, 16, and 24 months with standard neuropsychological tests and comprehensive geriatric assessment. Results: A cross-sectional baseline analysis found the expected inverse association of age with cognition in both groups, with survivors performing lower overall than controls in learning and memory (LM). Younger survivors, i.e., those under 75 years of age, exhibited lower performance in both LM and attention, and processing speed and executive function (APE), compared to controls, with no differences being observed between older survivors and controls, which tracked with deficit accumulation trends. Conclusion: Cognitive differences between the survivors and controls for the LM and APE domains were prominent in younger survivors, as was deficit accumulation, suggesting a mediating effect on cognition. Deficit accumulation may represent a modifiable risk factor in cancer survivorship that may be targeted for prevention and intervention.

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“…The data reported here was collected as part of a collaboration between Memorial Sloan Kettering Cancer Center and City of Hope (PIs: Ahles; Hurria) that assessed cognition in controls and breast cancer survivors (age 60 or greater) who were all at least 5 years post-treatment and followed prospectively over 2 years with 4 timepoints at 8-month intervals [35]. In this secondary analysis we examined data derived from the first timepoint across a longer 5 to 15 year interval, in 4 quartiles, as a proxy indicator of how cognitive trajectories might be altered given a history of cancer and cancer treatment.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Aging in Older Breast Cancer Survivors

Root¹,

Li²,

Schofield³

et al. 2023

Preprint

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Background: Cancer and cancer treatments may affect aging processes, altering the trajectory of cognitive aging, but extant studies are limited in interval of assessment (2-5 years). We studied cognitive performance in a cohort of survivors and controls utilizing cross-sectional cognitive performance data from age 60 to 89 years as an indicator of potential aging trajectories and contrasted these trends with longitudinal data collected over two years. Methods: Female breast cancer survivors who had been diagnosed and treated at age 60 or older and were 5– to 15-year survivors (N=328) and non-cancer controls (N=158) were assessed at enrollment and at 8, 16 and 24 months with standard neuropsychological tests and comprehensive geriatric as-sessment. Results: Cross-sectional baseline analysis found the expected inverse association of age with cognition in both groups, with survivors performing lower than controls in learning and memory (LM) but not in attention, processing speed and executive function (APE). Younger survivors, i.e., those under 75 years of age, exhibited early decline in performance in both LM and APE compared to controls, with no differences between older survivors and controls, which tracked with deficit accumulation trends. Conclusion: Differences between survivors and controls were prominent in younger survivors, as was deficit accumulation, suggesting a mediating effect on cognition. Deficit accumulation may represent a modifiable risk factor in cancer survivorship that may be targeted for prevention and intervention.

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The impact of APOE and smoking history on cognitive function in older, long-term breast cancer survivors

Cited by 4 publications

References 54 publications

Brain white matter microstructural changes in chemotherapy‐treated older long‐term breast cancer survivors

Brain white matter microstructural changes in chemotherapy‐treated older long‐term breast cancer survivors

Cognitive Aging in Older Breast Cancer Survivors

Cognitive Aging in Older Breast Cancer Survivors

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