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Supportive Care in Cancer

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01-03-2021 | Fatigue | Original Article

Correlates of cognitive impairment in adult cancer survivors who have received chemotherapy and report cognitive problems

Authors: Shannon L. Gutenkunst, Janette L. Vardy, Haryana M. Dhillon, Melanie L. Bell

Published in: Supportive Care in Cancer | Issue 3/2021

Abstract

Objective

Cognitive impairment negatively affects some cancer survivors who have completed chemotherapy; however, factors underlying this cognitive impairment remain poorly understood. We aimed to investigate (1) the relative importance of demographics, medical, and psychological characteristics associated with cognitive impairment and (2) the specific variables associated with cognitive impairment in adult cancer survivors who completed adjuvant chemotherapy.

Methods

We performed post hoc analyses of baseline data from early-stage cancer survivors with cognitive complaints who received adjuvant chemotherapy 0.5–5 years earlier and volunteered for a trial designed to improve cognition. The primary outcome of self-reported cognitive impairment was measured using a questionnaire; secondary outcome of objective cognitive impairment was measured using a computerized neuropsychological test battery. Hierarchical linear regression determined the relative importance of demographics, medical, and psychological characteristics in associations with both self-reported and objective cognitive impairment.

Results

The sample was 95% female and 89% breast cancer patients. The final model accounted for 33% of variation in self-reported cognitive impairment (n = 212, demographics 5%, medical 3%, and psychological 25%), with fatigue and stress as significant individual correlates (p values ≤ 0.0001). For the secondary analysis, the final model accounted for 19% of variation in objective cognitive impairment (n = 206, demographics 10%, medical 5%, and psychological 4%), with age, smoking history, and number of chemotherapy cycles as significant individual correlates.

Conclusion

We found that psychological characteristics are more important than demographic and medical characteristics in self-reported cognitive impairment, whereas other characteristics are more important in objective cognitive impairment. This suggests clinicians should investigate possible psychological problems in cancer survivors who self-report cognitive impairment.

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Title: Correlates of cognitive impairment in adult cancer survivors who have received chemotherapy and report cognitive problems
Authors: Shannon L. Gutenkunst
Janette L. Vardy
Haryana M. Dhillon
Melanie L. Bell
Publication date: 01-03-2021
Publisher: Springer Berlin Heidelberg
Keywords: Fatigue
Cytostatic Therapy
Published in: Supportive Care in Cancer / Issue 3/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05616-5

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Abstract

Objective

Methods

Results

Conclusion

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