scholarly journals Cognitive Complaints in Survivors of Breast Cancer After Chemotherapy Compared With Age-Matched Controls: An Analysis From a Nationwide, Multicenter, Prospective Longitudinal Study

2017 ◽  
Vol 35 (5) ◽  
pp. 506-514 ◽  
Author(s):  
Michelle C. Janelsins ◽  
Charles E. Heckler ◽  
Luke J. Peppone ◽  
Charles Kamen ◽  
Karen M. Mustian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Reading Ability ◽  
Menopausal Status ◽  
Prospective Longitudinal Study ◽  
Cognitive Difficulties ◽  
Community Oncology ◽  
Prospective Longitudinal

Purpose Cancer-related cognitive impairment is an important problem for patients with breast cancer, yet its trajectory is not fully understood. Some previous cancer-related cognitive impairment research is limited by heterogeneous populations, small samples, lack of prechemotherapy and longitudinal assessments, use of normative data, and lack of generalizability. We addressed these limitations in a large prospective, longitudinal, nationwide study. Patients and Methods Patients with breast cancer from community oncology clinics and age-matched noncancer controls completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) at prechemotherapy and postchemotherapy and at a 6-month follow-up as an a priori exploratory aim. Longitudinal models compared FACT-Cog scores between patients and controls at the three assessments and adjusted for age, education, race, menopausal status, and baseline reading ability, anxiety, and depressive symptoms. A minimal clinically important difference cutoff determined percentages of impairment over time. Results Of patients, 581 patients with breast cancer (mean age, 53 years; 48% anthracycline-based regimens) and 364 controls (mean age, 53 years) were assessed. Patients reported significantly greater cognitive difficulties on the FACT-Cog total score and four subscales from prechemotherapy to postchemotherapy compared with controls as well as from prechemotherapy to 6-month follow-up (all P < .001). Increased baseline anxiety, depression, and decreased cognitive reserve were significantly associated with lower FACT-Cog total scores. Treatment regimen, hormone, or radiation therapy was not significantly associated with FACT-Cog total scores in patients from postchemotherapy to 6-month follow-up. Patients were more likely to report a clinically significant decline in self-reported cognitive function than were controls from prechemotherapy to postchemotherapy (45.2% v 10.4%) and from prechemotherapy to 6-month follow-up (36.5% v 13.6%). Conclusion Patients with breast cancer who were treated in community oncology clinics report substantially more cognitive difficulties up to 6 months after treatment with chemotherapy than do age-matched noncancer controls.

scholarly journals An Evaluation of DNA Methyltransferase 1 (DNMT1) Single Nucleotide Polymorphisms and Chemotherapy-Associated Cognitive Impairment: A Prospective, Longitudinal Study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Alexandre Chan ◽  
Angie Yeo ◽  
Maung Shwe ◽  
Chia Jie Tan ◽  
Koon Mian Foo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cancer Patients ◽  
Dna Methyltransferase ◽  
Dna Methyltransferases ◽  
Breast Cancer Patients ◽  
Prospective Longitudinal Study ◽  
Cognitive Domains ◽  
Prospective Longitudinal

Abstract Strong evidence suggests that genetic variations in DNA methyltransferases (DNMTs) may alter the downstream expression and DNA methylation patterns of neuronal genes and influence cognition. This study investigates the association between a DNMT1 polymorphism, rs2162560, and chemotherapy-associated cognitive impairment (CACI) in a cohort of breast cancer patients. This is a prospective, longitudinal cohort study. From 2011 to 2017, 351 early-stage breast cancer patients receiving chemotherapy were assessed at baseline, the midpoint, and the end of chemotherapy. DNA was extracted from whole blood, and genotyping was performed using Sanger sequencing. Patients’ self-perceived cognitive function and cognitive performance were assessed at three different time points using FACT-Cog (v.3) and a neuropsychological battery, respectively. The association between DNMT1 rs2162560 and cognitive function was evaluated using logistic regression analyses. Overall, 33.3% of the patients reported impairment relative to baseline in one or more cognitive domains. Cognitive impairment was observed in various objective cognitive domains, with incidences ranging from 7.2% to 36.9%. The DNMT1 rs2162560 A allele was observed in 21.8% of patients and this was associated with lower odds of self-reported cognitive decline in the concentration (OR = 0.45, 95% CI: 0.25–0.82, P = 0.01) and functional interference (OR = 0.48, 95% CI: 0.24–0.95, P = 0.03) domains. No significant association was observed between DNMT1 rs2162560 and objective cognitive impairment. This is the first study to show a significant association between the DNMT1 rs2162560 polymorphism and CACI. Our data suggest that epigenetic processes could contribute to CACI, and further studies are needed to validate these findings.

scholarly journals Parkinson’s disease: evolution of cognitive impairment and CSF Aβ1–42 profiles in a prospective longitudinal study

2018 ◽  
Vol 90 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Stefanie Lerche ◽  
Isabel Wurster ◽  
Benjamin Röben ◽  
Gerrit Machetanz ◽  
Milan Zimmermann ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cox Regression ◽  
Disease Process ◽  
Amyloid Β ◽  
Prospective Longitudinal Study ◽  
Disease Evolution ◽  
Prospective Longitudinal

ObjectiveTo evaluate the evolution of cognitive impairment in relation to cerebrospinal fluid (CSF) profiles of amyloid-β (Aβ), total-Tau and phosphorylated-Tau in Parkinson’s disease (PD).MethodsProspective, longitudinal, observational study up to 10 years with follow-up every 2  years. We assessed CSF profiles in 415 patients with sporadic PD (median age 66; 63% men) and 142 healthy controls (median age 62; 43% men).ResultsPatients with PD with low CSF Aβ1–42 levels at baseline were more often cognitively impaired than patients with intermediate and high Aβ1–42 levels. Sixty-seven per cent of the patients with low Aβ1–42 levels at baseline and normal cognition developed cognitive impairment during follow-up, compared with 41% and 37% of patients having intermediate and high CSF Aβ1–42 levels. Kaplan-Meier survival curves and Cox regression revealed that patients with low CSF Aβ1–42 levels at baseline developed cognitive impairment more frequently and earlier during follow-up.ConclusionWe conclude that in patients with sporadic PD, low levels of Aβ1–42 are associated with a higher risk of developing cognitive impairment earlier in the disease process at least in a subgroup of patients.

scholarly journals The association between cancer-related fatigue and diabetes from pre-chemotherapy to 6-months post-chemotherapy

2021 ◽  
Author(s):  
Amber Kleckner ◽  
Ian R. Kleckner ◽  
Eva Culakova ◽  
Michelle Shayne ◽  
Elizabeth K. Belcher ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Repeated Measures ◽  
Diabetes Management ◽  
Menopausal Status ◽  
Secondary Analysis ◽  
Prospective Longitudinal Study ◽  
Cancer Related Fatigue ◽  
Diabetes Status ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Purpose To quantify the impact of diabetes on the trajectory of cancer-related fatigue (CRF) from pre-chemotherapy to 6 months post-chemotherapy for patients with breast cancer compared to non-cancer controls.Methods This was a secondary analysis from a nationwide prospective longitudinal study of female patients with breast cancer undergoing chemotherapy and age-matched women without cancer (controls). CRF was measured using the Multidimensional Fatigue Symptom Inventory (MFSI) pre-, post-, and 6-months post-chemotherapy in patients; controls were assessed at equivalent time points. Diabetes status was obtained at baseline. Repeated measures mixed models estimated the association between CRF and diabetes controlling for cancer (y/n), body mass index, exercise and smoking habits, baseline anxiety and depressive symptoms, menopausal status, marital status, race, and education.Results A total of 439 patients and 235 controls (age: 52.8±10.5 years) had available data on diabetes status. Diabetes was twice as prevalent among patients as controls (11.6% vs. 6.8%). Patients had worse fatigue than controls throughout treatment (p<0.001). Diabetes was associated with worse CRF with a clinically meaningful difference of 4.7±1.7 points on the fatigue measure in all participants (p=0.009) and patients alone (p=0.030). For MFSI subdomains, diabetes was associated with worse general (p=0.002), physical (p=0.005), and mental fatigue (p=0.025) but not worse emotional fatigue or vigor (p>0.14) among patients. Conclusions Diabetes was twice as prevalent in women with breast cancer compared to controls, and diabetes was associated with more severe CRF in patients before and after chemotherapy and at 6 months post-chemotherapy. Interventions that address diabetes management may also help address CRF during chemotherapy treatment

scholarly journals Can Clinical Data Predict Progression to Dementia in Amnestic Mild Cognitive Impairment?

2008 ◽  
Vol 35 (3) ◽  
pp. 314-322 ◽  
Author(s):  
Lesley Fellows ◽  
Howard Bergman ◽  
Christina Wolfson ◽  
Howard Chertkow
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Clinical Data ◽  
Symptom Onset ◽  
Amnestic Mild Cognitive Impairment ◽  
Elderly Subjects ◽  
Prospective Longitudinal Study ◽  
Amnestic Mci ◽  
Prospective Longitudinal

Background:To determine whether clinical data obtained by history and physical examination can predict eventual progression to dementia in a cohort of elderly people with mild cognitive impairment.Methods:A prospective, longitudinal study of a cohort of elderly subjects with amnestic Mild Cognitive Impairment (MCI). Ninety subjects meeting the criteria for amnestic MCI were recruited and followed annually for an average of 3.3 years. Main outcome measure was the development of dementia determined by clinical assessment with confirmatory neuropsychological evaluation.Results:Fifty patients (56%) developed dementia on follow-up. They were older, had lower Mini-mental status exam (MMSE) scores and a shorter duration of symptoms at the time of first assessment. Multivariate logistic regression analysis identified age at symptom onset as the only clinical parameter which distinguished the group that deteriorated to dementia from the group that did not. The odds ratio for age was 1.1 (confidence interval 1.04 - 1.18).Conclusions:Patients presenting with amnestic MCI insufficient for the diagnosis of dementia are at high risk of developing dementia on follow-up. In our cohort, 56% were diagnosed with dementia over an average period of 5.9 years from symptom onset. The only clinical predictor for the eventual development of dementia was older age at symptom onset. Clinical features alone were insufficient to predict development of dementia.

Does adjuvant chemotherapy (CT) exacerbate cognitive impairment in elderly breast cancer (BC) patients? Results of a prospective, longitudinal study

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10530-10530
Author(s):  
M. B. Rodin ◽  
J. A. Wallace ◽  
M. Lacy ◽  
K. Kuball ◽  
B. Pykkonen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cognitive Impairment ◽  
Elderly Women ◽  
Fine Motor ◽  
Motor Speed ◽  
Prospective Longitudinal Study ◽  
Post Menopausal ◽  
A Prospective Study ◽  
Chemo Brain ◽  
Prospective Longitudinal

10530 Background: Over the last few years, several retrospective studies documented cognitive impairment in post-chemotherapy BC patients. This decline was hypothesized to be related to CT (“chemo-brain”). More recently, a prospective study (Wefel et al. 2005) documented significant cognitive impairment at baseline, which may impact response to CT, along with treatment related effects. While all previous studies focused on the cognitive response of young BC women, older patients may be much more susceptible to any CT related neurotoxicity. Thus, the current study investigated the incidence and course of cognitive impairment in older, post-menopausal BC patients undergoing CT. Methods: 19 postmenopausal women (≥50 yrs) with no prior chemo or hormonal cancer treatment, and baseline MMSE >23 completed a comprehensive neurocognitive battery of tests along with anxiety and depression measures, prior to treatment. At 6 months, 12 patients returned for post-chemotherapy evaluation, with 8 evaluated at 2 years. Ten DCIS patients were also evaluated at baseline and 6 months. Results: Mean age at baseline was 67 yrs with 14 years of education. Prior to treatment, 37% displayed significant cognitive impairment not accounted for by other variables. At six months, within and between group analyses revealed only improved fine motor speed (Finger tapping, p.01) related to practice effects, but no decline in cognitive functions. There were no significant differences across measures between BC and DCIS groups. However, RCI revealed 3 of 12 BC patients improved on memory tasks. Two year longitudinal analyses again revealed improved motor speed and possible cognitive flexibility (TMT-A, p.02), along with decreased anxiety (STAI-S, p = .03). Conclusion: This small study does not support a finding of treatment-associated cognitive impairment among elderly women receiving standard CT for breast cancer. However, like Wefel’s sample, we documented significant cognitive impairment prior to initiation of treatment. Studies addressing the etiologic mechanism related to this cognitive dysfunction are warranted. Limitations of the current study will be discussed. No significant financial relationships to disclose.

scholarly journals Study of Chemotherapy-Induced Cognitive Impairment in Women with Breast Cancer

2020 ◽  
Vol 17 (23) ◽  
pp. 8896
Author(s):  
Blanca Rodríguez Martín ◽  
Eduardo José Fernández Rodríguez ◽  
María Isabel Rihuete Galve ◽  
Juan Jesús Cruz Hernández
Keyword(s):  
Breast Cancer ◽  
Quality Of Life ◽  
Cognitive Impairment ◽  
Cognitive Performance ◽  
Anxiety And Depression ◽  
Oncology Patients ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal ◽  
The Impact

Background: Oncology patients experience a large number of symptoms and, those referring to cognitive performance has an ever-increasing importance in clinical practice, due to the increase in survival rates and interest in the patient’s quality of life. The studies reviewed showed that chemotherapy-related cognitive impairment might occur in 15 and 50% of oncology patients. The main objective of this research was to study the impact of chemotherapy on the cognitive function of patients with locoregional breast cancer. Method: Analytical, prospective, longitudinal study using three measures, unifactorial intrasubject design, non-probability, and random selection sampling. The sample comprised women newly diagnosed with locoregional breast cancer in stages I, II, IIIA who received chemotherapy at the University Hospital of Salamanca (Complejo Asistencial Universitario de Salamanca), randomly selected for three years. Semi-structured interviews were conducted, and anxiety and depression (Hospital Anxiety and Depression scale, HAD); quality of life (QLQ-BR23 scale) and the following cognitive variables were assessed—processing speed, attention, memory, and executive functions (subtests of the Wechsler Intelligence Scale and the Trail Making Test). Results: The final sample size included 151 participants; 23 were excluded. A decline in cognitive performance was observed in patients, which did not completely recover two months after chemotherapy was completed. Additionally, worse cognitive performance was observed in patients with anxious or depressive symptoms. There was a negative impact on the quality of life. Conclusion: Chemotherapy had an impact on the cognitive performance of oncology patients in most cognitive domains studied.

Differential impacts of duration of untreated psychosis (DUP) on cognitive function in first-episode schizophrenia according to mode of onset

2015 ◽  
Vol 30 (8) ◽  
pp. 995-1001 ◽  
Author(s):  
S. Ito ◽  
T. Nemoto ◽  
N. Tsujino ◽  
N. Ohmuro ◽  
K. Matsumoto ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Social Functioning ◽  
First Episode ◽  
Duration Of Untreated Psychosis ◽  
Prospective Longitudinal Study ◽  
Insidious Onset ◽  
First Episode Schizophrenia ◽  
Prospective Longitudinal ◽  
Onset Group

AbstractBackgroundThe mode of onset and the course of schizophrenia illness exhibit substantial individual variations. Previous studies have pointed out that the mode of onset affects the duration of untreated psychosis (DUP) and clinical outcomes, such as cognitive and social functioning. This study attempted to clarify the association between the DUP and clinical features, taking the different modes of onset into consideration, in a prospective longitudinal study examining patients with first-episode schizophrenia.MethodsThis study was conducted in six areas of Japan. Patients with first-episode schizophrenia were followed for over 18 months. Cognitive function, psychopathology, and social functioning were assessed at baseline and at 6, 12, and 18-month follow-up points.ResultsWe identified 168 patients and sufficient information was available to determine the DUP and the mode of onset for 156 patients (92.9%): 79 had an acute onset, and 77 had an insidious onset. The DUP was significantly associated with quality of life (QOL), social functioning, and cognitive function at most of the follow-up points in the insidious-onset group. The DUP and negative symptoms at baseline were significant predictors of cognitive function at the 18-month follow-up in the insidious-onset group.ConclusionsThe present results further support the hypothesis that the DUP affects QOL, social functioning, and cognitive function over the course of illness, especially in patients with an insidious onset. Effective strategies for detecting and caring for individuals with insidious onset early during the course of schizophrenia will be essential for achieving a full patient recovery.

Sign in / Sign up

Export Citation Format

Share Document