scholarly journals Reductions in sleep quality and circadian activity rhythmicity predict longitudinal changes in objective and subjective cognitive functioning in women treated for breast cancer

2021 ◽  
Author(s):  
Sonia Ancoli-Israel ◽  
Lianqi Liu ◽  
Loki Natarajan ◽  
Michelle Rissling ◽  
Ariel B. Neikrug ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Function ◽  
Sleep Quality ◽  
Cognitive Functioning ◽  
Test Performance ◽  
Neuropsychological Functioning ◽  
Practice Effect ◽  
Circadian Activity ◽  
Time Points ◽  
One Year

Abstract Purpose To examine long-term cognitive effects of chemotherapy and identify predictors among women with breast cancer (WBC). Patients and methods Sixty-nine WBC scheduled to receive chemotherapy, and 64 matched-controls with no cancer, participated. Objective and subjective cognition, total sleep time, nap time, circadian activity rhythms (CAR), sleep quality, fatigue, and depression were measured pre-chemotherapy (Baseline), end of cycle 4 (Cycle-4), and one-year post-chemotherapy (1-Year). Results WBC showed no change in objective cognitive measures from Baseline to Cycle-4 but significantly improved from both time points to 1-Year. Matched-controls showed an increase in test performance at all time points. WBC had significantly higher self-reported cognitive dysfunction at Cycle-4 and 1-Year compared to baseline and compared to matched-controls. Worse neuropsychological functioning was predicted by less robust CARs (i.e., inconsistent 24 h pattern), worse sleep quality, longer naps, and worse cognitive complaints. Worse subjective cognition was predicted by lower sleep quality and higher fatigue and depressed mood. Conclusion Objective testing showed increases in performance scores from pre- and post-chemotherapy to one year later in WBC, but matched-controls showed an increase in test performance from baseline to Cycle-4 and from Cycle-4 to 1-Year, likely due to a practice effect. The fact that WBC showed no practice effects may reflect a form of learning deficit. Compared with the matched-controls, WBC reported significant worsened cognitive function. In WBC, worse objective and subjective cognitive functioning were predicted by worse sleep and sleep-related behaviors (naps and CAR). Interventions that target sleep, circadian rhythms, and fatigue may benefit cognitive function in WBC.

scholarly journals Longitudinal Trajectories of Cognitive Function after Stroke: A Prospective Cohort Study

2021 ◽  
Author(s):  
Dongni Buvarp ◽  
Lena Rafsten ◽  
Tamar Abzhandadze ◽  
Katharina S. Sunnerhagen
Keyword(s):  
Cognitive Function ◽  
Cognitive Functioning ◽  
First Year ◽  
Cognitively Impaired ◽  
Swedish Population ◽  
Longitudinal Trajectories ◽  
Memory Problems ◽  
Trajectory Models ◽  
One Year ◽  
The Impact

Abstract Background The study aimed to determine longitudinal trajectories of cognitive function during the first year after stroke. MethodsThe Montreal Cognitive Assessment (MoCA) was used to screen cognitive function at 36-48 hours, 3-months, and 12-months post-stroke. Individuals who shared similar trajectories were classified by applying the group-based trajectory models. ResultsData from 94 patients were included in the analysis. Three cognitive functioning groups were identified by the trajectory models: high (14 patients [15%]), medium (58 [62%]) and low (22 [23%]). For the high and medium groups, cognitive function improved at 12 months, but this did not occur in the low group. After age, sex and education matching to normative MoCA form the Swedish population, 52 patients (55%) were found to be cognitively impaired at baseline, and few patients had recovered at 12 months. The impact on memory differs between cognitive functioning groups, whereas the impact on activities of daily live was not different.ConclusionsPatients with the poorest cognitive function did not improve at one-year poststroke and were prone to severe memory problems. These findings may help to increase focus on long-term rehabilitation plans for those patients, and to more accurately assess their needs and difficulties experienced in daily living.

EEG for evaluation of “chemobrain.”

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 1076-1076
Author(s):  
Halle C. F. Moore ◽  
Michael W. Parsons ◽  
Guang H. Yue ◽  
Lisa A. Rybicki ◽  
Vlodek Siemionow
Keyword(s):  
Breast Cancer ◽  
Repeated Measures ◽  
Cognitive Task ◽  
Mental Fatigue ◽  
Cognitive Testing ◽  
Physical Endurance ◽  
Adult Intelligence Scale ◽  
Time Points ◽  
Physical Task ◽  
One Year

1076 Background: Cognitive impairment is a poorly understood and worrisome potential complication of adjuvant chemotherapy (CT). We sought to evaluate electroencephalography (EEG) as a means to measure neurophysiologic function in women receiving CT for early breast cancer. Methods: Women planning to undergo CT for operable breast cancer and age-similar controls were evaluated at baseline, during CT and at 1 year with neurophysiologic assessments. Testing included a brief fatigue inventory (BFI), brief mental fatigue assessment (BMF), Processing Speed Index (PSI) derived from Digit Symbol Coding and Symbol Search subtests of the Wechsler Adult Intelligence Scale, and a sustained elbow flexion physical task (PT). EEG recordings were obtained at rest and after the cognitive and physical tasks. Data were analyzed using repeated measures of analysis of variance. Results: Eight patient/control pairs completed baseline and on-treatment evaluations; 7 pairs also completed the 1 year assessment (1 pair withdrawn due to a second malignancy). Subjective mental fatigue measured by BMF is similar for patients and controls at baseline but BMF scores increase significantly during CT for patients relative to controls (p=0.033), recovering to no difference at one year. Differences in PSI are not observed between patients and controls or at the different time points. BFI scores are greater in patients at all 3 time points but endurance on the PT is no different from controls. During chemotherapy EEG total spectrum amplitudes in patients are greater than in controls at rest (p=0.05) and following both the cognitive (p<0.001) and physical (p<0.001) tasks. EEG activity prior to chemotherapy and at one year is not different between patients and controls. For patients but not controls EEG readings after the cognitive task demonstrate greater amplitude than pre-task readings during the time of CT treatment only (p=0.012) with a similar trend seen for the physical task (p=0.06). Conclusions: Patient-perceived mental and physical fatigue during chemotherapy correspond to significant changes in EEG brain activity patterns but not to cognitive testing or physical endurance testing. EEG may offer a sensitive means to measure alterations in brain function associated with CT.

174 Discrimination moderates the association of sleep and cognitive function in older Black adults: The Einstein Aging Study

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A71-A71
Author(s):  
Linying Ji ◽  
June Jiao ◽  
Ruixue Zhaoyang ◽  
Carol Derby ◽  
Orfeu Buxton ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Sleep Quality ◽  
Cognitive Functioning ◽  
Skin Color ◽  
Sleep Onset ◽  
Individual Characteristics ◽  
Black Adults ◽  
Memory Binding ◽  
Wrist Actigraphy ◽  
Aging Study

Abstract Introduction Experiences of discrimination attributed to a range of individual characteristics (race, skin color, age, sex, etc.) may influence the extent to which sleep impacts cognitive functioning in order adults, particularly within older minorities. Thus, we investigated the effect of discrimination on the relationship between actigraphic sleep quality and cognitive function in analyses stratified by race. Methods Participants (N=286, mean age=77.4 years, 32% males; 45% white, 41% Black, 14% Hispanic/others) enrolled in The Einstein Aging Study were included. Sleep disturbance, as measured by wake after sleep onset (WASO) (mean=63 min, sd=27 min), was calculated from wrist actigraphy over 15.4±1.4 days. Participants’ mean ambulatory cognitive function was assessed with a validated, memory binding, smartphone-based EMA task (Color Shapes) repeated 4 times daily. A modified version of the Williams’ Everyday Discrimination questionnaire, optimized for older adults, measured participants’ endorsement of discriminated characteristics. Linear regressions, stratified by race (white, Black separately), were conducted with interaction terms to investigate whether discrimination moderated associations between WASO and ambulatory cognitive function. Models controlled for age, education, income, and gender. Regions of significance were also evaluated. Results Race-stratified analysis indicated that the association between mean WASO and cognitive function was significantly moderated by the number of discriminated characteristics among Black adults (n=117), not whites (n=128). Specifically, among Black adults who identified few discriminated characteristics, WASO was not significantly associated with memory binding. However, Black adults who identified discriminated characteristics at +1 SD above the mean (5.5 traits) exhibited a 12% lower average memory binding test score (percent responses correct) with each half-hour greater mean WASO (p=.01). Analysis of the region of significance showed the association is significant when participants endorsed more than three discriminated characteristics. Conclusion These findings emphasize the importance of considering sociocultural factors, such as discrimination, to understand the association between sleep quality and cognitive functioning, particularly for older Blacks. Support (if any) R01AG062622

Relationships between self-reported sleep quality components and cognitive functioning in breast cancer survivors up to 10 years following chemotherapy

2018 ◽  
Vol 27 (8) ◽  
pp. 1937-1943 ◽  
Author(s):  
Ashley M. Henneghan ◽  
Patricia Carter ◽  
Alexa Stuifbergan ◽  
Brennan Parmelee ◽  
Shelli Kesler
Keyword(s):  
Breast Cancer ◽  
Sleep Quality ◽  
Cancer Survivors ◽  
Cognitive Functioning ◽  
Breast Cancer Survivors

Subjective cognitive complaints one year after ceasing adjuvant endocrine therapy for early-stage breast cancer: Findings from the Breast International Group (BIG) 1-98 trial.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9022-9022
Author(s):  
Kelly-Anne Phillips ◽  
Karin Ribi ◽  
Julie Aldridge ◽  
Alastair Mark Thompson ◽  
Vernon J. Harvey ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Function ◽  
Postmenopausal Women ◽  
Endocrine Therapy ◽  
Patient Reported Outcomes ◽  
Adjuvant Endocrine Therapy ◽  
The Other ◽  
Subjective Cognitive Function ◽  
Patient Reported ◽  
One Year

9022 Background: We have previously reported that, in the BIG 1-98 trial, objective cognitive function improved in postmenopausal women one year after cessation of adjuvant endocrine therapy for breast cancer. Here we evaluate changes in subjective cognitive function (SCF). Methods: One hundred postmenopausal women, randomized to receive five years of adjuvant tamoxifen, letrozole, or sequences of both, completed self-reported measures on SCF, psychological distress, fatigue and quality of life during the fifth year of trial treatment (year 5) and one year after treatment completion (year 6). Changes between years 5 and 6 were evaluated using the Wilcoxon signed-rank test. SCF and its correlates were explored. Results: Mean age of participants was 63.9 years [SD=7.1 years]. SCF and the other patient-reported outcomes did not change significantly after cessation of endocrine therapy with the exception of improvement in hot flushes (p=0.0005). No difference in changes was found between women who were taking tamoxifen or letrozole at year 5. SCF was the only psychosocial outcome with a substantial correlation between year 5 and 6 (Spearman’s R=0.80). Correlations between SCF and the other patient-reported outcomes were generally low. Conclusions: Although objective cognitive function improved after cessation of adjuvant endocrine therapy in the BIG 1-98 trial, improvement in SCF was not evident. The underlying reason for the clear disconnect between objective and subjective cognitive function seen in this and most other studies, is a crucial issue. It should be a research priority in order to effectively tackle the concerns of women about their cognition during and after breast cancer treatment.

scholarly journals A prospective cohort study on longitudinal trajectories of cognitive function after stroke

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Dongni Buvarp ◽  
Lena Rafsten ◽  
Tamar Abzhandadze ◽  
Katharina S. Sunnerhagen
Keyword(s):  
Cognitive Function ◽  
Cognitive Functioning ◽  
Daily Living ◽  
First Year ◽  
Swedish Population ◽  
Longitudinal Trajectories ◽  
Memory Problems ◽  
Trajectory Models ◽  
One Year ◽  
The Impact

AbstractThe study aimed to determine longitudinal trajectories of cognitive function during the first year after stroke. The Montreal Cognitive Assessment (MoCA) was used to screen cognitive function at 36–48 h, 3-months, and 12-months post-stroke. Individuals who shared similar trajectories were classified by applying the group-based trajectory models. Data from 94 patients were included in the analysis. Three cognitive functioning groups were identified by the trajectory models: high [14 patients (15%)], medium [58 (62%)] and low [22 (23%)]. For the high and medium groups, cognitive function improved at 12 months, but this did not occur in the low group. After age, sex and education matching to the normative MoCA from the Swedish population, 52 patients (55%) were found to be cognitively impaired at baseline, and few patients had recovered at 12 months. The impact on memory differs between cognitive functioning groups, whereas the impact on activities of daily living was not different. Patients with the poorest cognitive function did not improve at one-year poststroke and were prone to severe memory problems. These findings may help to increase focus on long-term rehabilitation plans for those patients, and more accurately assess their needs and difficulties experienced in daily living.

Effect of physical exercise on cognitive function after chemotherapy in patients with breast cancer: A randomized controlled trial (PAM study).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 12015-12015
Author(s):  
Emmie Koevoets ◽  
Sanne B. Schagen ◽  
Michiel B. de Ruiter ◽  
Mirjam I Geerlings ◽  
Lenja Witlox ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Function ◽  
Physical Exercise ◽  
Physical Fitness ◽  
Cognitive Functioning ◽  
Exercise Intervention ◽  
Verbal Learning ◽  
Control Group ◽  
Positive Effects ◽  
Cognitive Problems

12015 Background: Chemotherapy is associated with cognitive problems. Physical exercise is a promising intervention. We investigated whether exercise improves cognition in chemotherapy-exposed breast cancer (BC) patients 2-4 years after diagnosis. Methods: In the PAM study, we randomized chemotherapy-exposed BC patients with self-reported and test-confirmed cognitive problems to an exercise or control group. The 6-month exercise intervention consisted of 2 hours of supervised aerobic and resistance training and two hours of Nordic/power walking. Memory function measured with the Hopkins Verbal Learning Test-Revised (HVLT-R) was our primary outcome. Further measurements included online neuropsychological tests (Amsterdam Cognition Scan; ACS), self-reported cognitive complaints (MDASI-MM, EORTC QLQ C-30 cognitive functioning), physical fitness (VO2peak), fatigue (MFI, EORTC fatigue), quality of life (QoL; EORTC), anxiety (HADS) and depression (HADS, PHQ9). HVLT-R total recall was analyzed with a Fisher exact test for clinically relevant improvement of ≥5 words. Other outcomes were analyzed using multiple regression analyses adjusted for baseline and stratification factors. An hypothesis driven but not pre-specified analysis in patients with high baseline EORTC fatigue levels (≥39) was performed. Results: We randomized 181 patients to the exercise (n = 91) or control group (n = 90). Two-third of the patients attended ≥ 80% of the exercise program and physical fitness significantly improved compared to the control patients ( VO2peak1.4 ml/min/kg, 95% CI 0.6; 2.2). No difference in favor of the intervention group was seen on the primary cognitive outcome or other cognitive tests. However, significant beneficial intervention effects were found for self-reported cognition (MDASI-MM Severity (-0.7, -1.2;-0.1)), fatigue (general fatigue (-2.2, -3.3; -1.1), physical fatigue (-3.3, -4.4; -2.2), mental fatigue (-1.0, -2.0; 0.0), reduced motivation (-1.1, -2.0; -0.2) and reduced activity (-2.1, -3.2; -1.1)), QoL (summary score (4.0, 1.2; 6.7), global health status (5.8, 1.1; 10.6), role functioning (7.2, 1.3; 13.1) and social functioning (5.9, 0.2; 11.6)) and depression (PHQ9 (-1.16, -2.19; -0.13)). In high-fatigued patients, exercise did show significant positive effects on objective cognitive function (ACS Reaction Time (-26.8, -52.9; -0.6) and ACS Wordlist Learning (4.4, 0.5; 8.3)). Conclusions: A 6-month exercise intervention did not improve objectively measured cognitive function in chemotherapy-exposed BC patients with cognitive problems. However, self-reported cognitive function, physical fitness, fatigue, QoL and depression did improve. Unplanned analysis indicated a small positive effect of exercise on cognitive functioning in high-fatigued patients. Clinical trial information: NTR6104.

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