Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance.
|Title||Cognitive complaints after breast cancer treatments: examining the relationship with neuropsychological test performance.|
|Publication Type||Journal Article|
|Year of Publication||2013|
|Authors||Ganz PA, Kwan L, Castellon SA, Oppenheim A, Bower JE, Silverman DHS, Cole SW, Irwin MR, Ancoli-Israel S, Belin TR|
|Journal||J Natl Cancer Inst|
|Date Published||2013 Jun 5|
|Keywords||Adult, Antineoplastic Agents, Anxiety, Breast Neoplasms, Chemotherapy, Adjuvant, Cognition, Depression, Fatigue, Female, Higher Nervous Activity, Humans, Linear Models, Longitudinal Studies, Memory, Middle Aged, Mild Cognitive Impairment, Multivariate Analysis, Neuropsychological Tests, Prospective Studies, Radiotherapy, Adjuvant, Self Report, Surveys and Questionnaires|
BACKGROUND: Cognitive complaints are reported frequently after breast cancer treatments. Their association with neuropsychological (NP) test performance is not well-established.
METHODS: Early-stage, posttreatment breast cancer patients were enrolled in a prospective, longitudinal, cohort study prior to starting endocrine therapy. Evaluation included an NP test battery and self-report questionnaires assessing symptoms, including cognitive complaints. Multivariable regression models assessed associations among cognitive complaints, mood, treatment exposures, and NP test performance.
RESULTS: One hundred eighty-nine breast cancer patients, aged 21-65 years, completed the evaluation; 23.3% endorsed higher memory complaints and 19.0% reported higher executive function complaints (>1 SD above the mean for healthy control sample). Regression modeling demonstrated a statistically significant association of higher memory complaints with combined chemotherapy and radiation treatments (P = .01), poorer NP verbal memory performance (P = .02), and higher depressive symptoms (P < .001), controlling for age and IQ. For executive functioning complaints, multivariable modeling controlling for age, IQ, and other confounds demonstrated statistically significant associations with better NP visual memory performance (P = .03) and higher depressive symptoms (P < .001), whereas combined chemotherapy and radiation treatment (P = .05) approached statistical significance.
CONCLUSIONS: About one in five post-adjuvant treatment breast cancer patients had elevated memory and/or executive function complaints that were statistically significantly associated with domain-specific NP test performances and depressive symptoms; combined chemotherapy and radiation treatment was also statistically significantly associated with memory complaints. These results and other emerging studies suggest that subjective cognitive complaints in part reflect objective NP performance, although their etiology and biology appear to be multifactorial, motivating further transdisciplinary research.
|Alternate Journal||J. Natl. Cancer Inst.|
|PubMed Central ID||PMC3672076|
|Grant List||P30 AG028748 / AG / NIA NIH HHS / United States |
P30-AG028748 / AG / NIA NIH HHS / United States
R01 CA 109650 / CA / NCI NIH HHS / United States
R01 HL095799 / HL / NHLBI NIH HHS / United States
R01-AG026364 / AG / NIA NIH HHS / United States
R01-AG034588 / AG / NIA NIH HHS / United States
R01-CA119159 / CA / NCI NIH HHS / United States
R01-HL079955 / HL / NHLBI NIH HHS / United States
R01CA112035 / CA / NCI NIH HHS / United States
UL RR 033176 / RR / NCRR NIH HHS / United States