Modifiable Risk Factors for Neurocognitive and Psychosocial Problems After Hodgkin Lymphoma

Blood ◽  
2021 ◽  
Author(s):  
AnnaLynn M Williams ◽  
Sedigheh Mirzaei Salehabadi ◽  
Mengqi Xing ◽  
Nicholas Steve Phillips ◽  
Matthew Ehrhardt ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hodgkin Lymphoma ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Cross Sectional ◽  
Chronic Health ◽  
Modifiable Factors ◽  
Task Efficiency

Long-term survivors of childhood Hodgkin lymphoma (HL) experience high burden of chronic health morbidities. Correlates of neurocognitive and psychosocial morbidity have not been well established. 1,760 survivors of HL (mean[SD] age 37.5[6.0] years, time since diagnosis 23.6[4.7] years, 52.1% female) and 3,180 siblings (age 33.2[8.5] years, 54.5% female) completed cross-sectional surveys assessing neurocognitive function, emotional distress, quality of life, social attainment, smoking, and physical activity. Treatment exposures were abstracted from medical records. Chronic health conditions were graded according to NCI CTCAE v4.3 (1=mild, 2=moderate, 3=severe/disabling, 4=life-threatening). Multivariable analyses, adjusted for age, sex, and race, estimated relative risk (RR) of impairment in survivors vs. siblings and, among survivors, risk of impairment associated with demographic, clinical, treatment factors and grade 2+ chronic health conditions. Compared with siblings, survivors had significant higher risk (p's<0.05) of neurocognitive impairment (e.g. memory 8.1% vs. 5.7%), anxiety (7.0%%vs. 5.4%),depression (9.1% vs. 7%), unemployment (9.6% vs. 4.4%), and impaired physical/mental quality of life (e.g. physical function 11.2% vs. 3.0%). Smoking was associated with higher risk of impairment in task efficiency (RR=1.56[1.02-2.39]), emotional regulation (RR=1.84[1.35-2.49]), anxiety (RR=2.43[1.51-3.93]), and depression (RR=2.73[1.85-4.04]). Meeting CDC exercise guidelines was associated with lower risk of impairment in task efficiency (RR=0.70[0.52-0.95]), organization (RR=0.60[0.45-0.80]), depression (RR=0.66[0.48-0.92]), and multiple quality of life domains. Cardiovascular and neurologic conditions were associated with impairment in nearly all domains. Survivors of HL are at elevated risk for neurocognitive and psychosocial impairment, and risk is associated with modifiable factors that provide targets for interventions to improve long-term functional outcomes.

scholarly journals Chronic health conditions related to quality of life for federal civil servants

2015 ◽  
Vol 36 (2) ◽  
pp. 35-41 ◽  
Author(s):  
Luciana Eduardo Fernandes Saraiva ◽  
Lays Pinheiro de Medeiros ◽  
Marjorie Dantas Medeiros Melo ◽  
Manuela Pinto Tiburcio ◽  
Isabelle Katherinne Fernandes Costa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Conditions ◽  
Civil Servant ◽  
Civil Servants ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Daily Work ◽  
Work And Life

OBJECTIVE: The aim of this study is to correlate the QOL domains of the civil servants to the type and number of chronic health conditions. METHOD: A transversal, quantitative study, conducted at the Department of Civil Servant Assistance of the Federal University of Rio Grande do Norte with 215 civil servants, during the period from March to May 2011. RESULTS: Among the chronic health conditions studied, there was significant relationship between non-communicable chronic disease and QOL scores, correlating weakly (r <-376; p <0.008) in the other fields. It was found that the greater the number of chronic conditions, the lower the values on the QOL scale. CONCLUSION: The quality of life of civil servants is negatively influenced by chronic health conditions, compromising, in general, their daily work and life activities.

scholarly journals Impact of the most frequent chronic health conditions on the quality of life among people aged >15 years in Madrid

2009 ◽  
Vol 20 (1) ◽  
pp. 78-84 ◽  
Author(s):  
M. E. y. Pena ◽  
R. J. Garcia ◽  
J. M. D. Olalla ◽  
E. V. Llanos ◽  
A. G. de Miguel ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health

scholarly journals Quality of Life and Self-Determination: Youth with Chronic Health Conditions Make the Connection

2015 ◽  
Vol 11 (2) ◽  
pp. 571-599 ◽  
Author(s):  
Janette McDougall ◽  
Patricia Baldwin ◽  
Jan Evans ◽  
Megan Nichols ◽  
Nicole Etherington ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Health Conditions ◽  
Self Determination ◽  
Health Conditions ◽  
Chronic Health

scholarly journals Prevalence and Predictors of Neurocognitive Impairment in Long-Term Survivors of Childhood Hodgkin Lymphoma: A Report from the Childhood Cancer Survivor Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 14-15
Author(s):  
Annalynn M Williams ◽  
Mengqi Xing ◽  
Sedigheh Mirzaei Salehabadi ◽  
Yutaka Yasui ◽  
Matt J. Ehrhardt ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Emotional Regulation ◽  
Neurocognitive Impairment ◽  
Elevated Risk ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Childhood Cancer Survivor Study ◽  
Task Efficiency ◽  
Long Term Survivors

Background: Long-term survivors of childhood Hodgkin lymphoma (HL) are at significant risk for cardiovascular, pulmonary, and endocrine morbidity in addition to subsequent cancers. Emerging evidence suggests that HL survivors may also experience persistent neurocognitive impairment, however the prevalence of neurocognitive impairment has not been well characterized. Further, little work has been done to examine how specific treatments or comorbidities are associated with these impairments. Methods: The current study included 1,760 survivors (52.0% female, mean[sd] 37.5 [6.0] years old, 23.6 [4.7] years from diagnosis) of childhood Hodgkin lymphoma and 3,180 sibling controls (54.5% female, 33.2 [8.5] years old) from the Childhood Cancer Survivor Study. Participants completed questionnaires assessing four domains of neurocognitive impairment (task efficiency, emotional regulation, organization, and memory). Impairment for each domain was defined as a score worse than the 90th percentile of community controls. Treatment exposures were abstracted from the medical record. Second malignancies (SMN) were self-reported and subsequently confirmed by pathology findings or medical record review. Chronic health conditions were self-reported and systematically graded according to the NCI CTCAE v4.3 (Grade 1 mild, Grade 2 moderate, Grade 3 severe/disabling, Grade 4 life-threatening). Generalized estimating equations were used to calculate risk of impairment in survivors compared with siblings adjusted for age, sex, and race. Among HL survivors, multivariable log-binomial regression was used to calculate risk of impairment associated with demographic, clinical, and treatment factors. Separate models examined risk associated with Grade 2+ chronic health conditions adjusted for age, sex, and race. Results: 10.8% of HL survivors reported impaired task efficiency (vs. 7.7% in siblings), 16.6% emotional regulation (vs. 11.5% in siblings), 12.1% organization (vs. 10.3% in siblings), and 8.1% memory (vs. 5.7% in siblings). Compared with siblings, survivors reported significantly higher risk of impairment in each of the four neurocognitive domains after adjusting for age, sex, and race (Table). Female survivors had elevated risk of impairment on emotional regulation (RR [95%CI] 1.4 [1.1,1.9)) and memory (2.0 [1.3,3.0]). Compared with white survivors (91.8% of the population), non-white survivors had higher risk of impairment in task efficiency (2.1 [1.2, 3.5]) and emotional regulation (1.7 [1.0,2.7]). Current smokers (12.3%) had higher risk of impairment in task efficiency (1.9 [1.2, 3.1]), emotional regulation (2.5 [1.7,3.7]), and memory (1.7 [1.0,3.0]). Having a late-relapse (&gt;5 years from diagnosis) or a second malignancy (20.0%) was associated with elevated risk of impairment in task efficiency (1.6 [1.06,2.3]). While not statistically significant, anthracycline exposure (39.8%) was associated with higher risk of impairment in task efficiency (1.3 [0.7,2.2]) and memory (1.6 [0.9,3.0]). No statistically significant associations were noted for bleomycin, corticosteroids, or chest radiation. HL survivors with pulmonary morbidity (8.5%) had a higher risk of impairment on task efficiency (1.9 [1.2,3.0]) compared to those without. Cardiovascular conditions (32.9%) were associated with elevated risk of impairment in all domains (RR range from 1.5 to 2.1, all p&lt;0.05, Table). Endocrine (54.3%) and neurologic conditions (6.6%) were associated with an increased risk of task efficiency, emotional regulation, and memory impairments (RR range from 1.4 to 5.5, all p&lt;0.05, Table). Conclusions: Survivors experienced significantly more neurocognitive impairment compared to sibling controls. Among survivors, potentially modifiable risk factors such as smoking and chronic health conditions were associated with neurocognitive impairment while treatment exposures showed little association. Mitigation or prevention of smoking and chronic health conditions may improve neurocognitive functioning in HL survivors Table Disclosures No relevant conflicts of interest to declare.

Impact of Perceived Health Competence on the Quality of Life of Emerging Adults With Chronic Health Conditions

2020 ◽  
pp. 216769682093864
Author(s):  
Amy C. Lang ◽  
Rachel N. Greenley ◽  
W. Hobart Davies
Keyword(s):  
Quality Of Life ◽  
Emerging Adults ◽  
Perceived Health ◽  
Chronic Health Conditions ◽  
Transitional Period ◽  
Health Conditions ◽  
Chronic Health ◽  
Health Competence ◽  
Perceived Health Competence

Emerging adults with chronic health conditions (CHCs) face additional challenges compared to their peers during this transitional period, which can exacerbate their symptoms and negatively impact their quality of life (QoL). This study assessed the impact of CHC status and the potential protective factor of perceived health competence (PHC) on QoL. Nine hundred twenty-nine emerging adults, aged 18–25 years ( M age = 22.19, SD = 1.95; 55% female), participated in the current study as part of a larger online survey. Results showed that those with a CHC reported significantly lower QoL than those without a CHC. Additionally, higher PHC was associated with higher QoL for both groups of emerging adults. Although the current study identified some factors that may differentially impact this positive association, the results consistently suggest that promotion of emerging adults’ PHC may play a key role in improving their QoL during this transitional period, regardless of CHC status.

scholarly journals Three-year trajectories of global perceived quality of life for youth with chronic health conditions

2016 ◽  
Vol 25 (12) ◽  
pp. 3157-3171 ◽  
Author(s):  
Janette McDougall ◽  
David J. DeWit ◽  
Megan Nichols ◽  
Linda Miller ◽  
F. Virginia Wright
Keyword(s):  
Quality Of Life ◽  
Perceived Quality ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Perceived Quality Of Life
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