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Journal of Cancer Survivorship

Open Access 04-01-2025

Frailty and neurocognitive impairments in Chinese survivors of childhood cancer

Authors: Yihui Wei, Weishang Deng, Kenneth Kin-Wah To, Teddy Tai-Ning Lam, Winnie Wan-Yee Tso, Agnes Sui-Yin Chan, Kirsten K. Ness, Chi Kong Li, Yin Ting Cheung

Published in: Journal of Cancer Survivorship

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Abstract

Purpose

This study aimed to evaluate the prevalence and predictors of frailty and the association between frailty and neurocognitive impairments among Chinese survivors of childhood cancer.

Methods

A total of 185 survivors of childhood cancer were recruited from a long-term follow-up clinic in Hong Kong (response rate: 94.4%; 48.1% female; mean age 28.9 years, standard deviation = 6.7 years). Frailty was assessed using the Fried frailty criteria. Neurocognitive outcomes were evaluated using a performance-based test. Multivariable logistic regression was used to identify the predictors of frailty. Multivariable generalized linear models were used to explore the associations between frailty and cognitive outcomes.

Results

The proportions of survivors with frailty and pre-frailty were 22.7% and 27.0%, respectively. “Frail” survivors were more likely to be diagnosed with cancer at a younger age (odds ratio [OR] = 0.93, 95% confidence interval [CI]: 0.87–0.99, P = 0.041) and to have coexisting chronic health conditions (OR = 4.63, 95% CI: 1.68–12.80, P = 0.003) than “non-frail” and “pre-frail” survivors. Survivors with frailty exhibited worse attention detectability (unstandardized point estimate [Est] = 4.57, standard error [SE] = 1.69, P = 0.007), omissions (Est = 3.68, SE = 1.15, P = 0.001), and cognitive flexibility (Est = 8.08, SE = 3.08, P = 0.009) than “non-frail” and “pre-frail” survivors.

Conclusions

More than one fifth of the participating Chinese survivors of childhood cancer were identified as phenotypically frail. Frailty was associated with worse performance in attention and executive function.

Implications for Cancer Survivors

The findings highlight the needs for regular monitoring and early interventions that can modify the aging pathway in the cancer continuum, to mitigate frailty and improve psychosocial outcomes during long-term cancer survivorship.
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Metadata
Title
Frailty and neurocognitive impairments in Chinese survivors of childhood cancer
Authors
Yihui Wei
Weishang Deng
Kenneth Kin-Wah To
Teddy Tai-Ning Lam
Winnie Wan-Yee Tso
Agnes Sui-Yin Chan
Kirsten K. Ness
Chi Kong Li
Yin Ting Cheung
Publication date
04-01-2025
Publisher
Springer US
Published in
Journal of Cancer Survivorship
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI
https://doi.org/10.1007/s11764-024-01739-4

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