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Vance DE, Fazeli PL, Azuero A, Frank JS, Wadley VG, Raper JL, Pope CN, Jacob A, Ball KK. A 2-Year, Randomized, Clinical Trial Examining the Effects of Speed of Processing Cognitive Training on Quality-of-Life Indicators in Adults With HIV-Associated Neurocognitive Disorder in Birmingham, Alabama: Results of the Think Fast Study. J Assoc Nurses AIDS Care 2024; 35:104-121. [PMID: 38949906 PMCID: PMC11217600 DOI: 10.1097/jnc.0000000000000449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2024]
Abstract
ABSTRACT Speed of processing (SOP) cognitive training may improve indicators of the quality of life (QoL) in people living with HIV. In this 2-year, longitudinal, randomized, controlled trial, 216 participants ages 40 years and older with HIV-associated neurocognitive disorder or borderline HIV-associated neurocognitive disorder were assigned to one of three groups: (a) 10 hr of SOP training (n = 70); (b) 20 hr of SOP training (n = 73), or (c) 10 hr of internet navigation control training (a contact control group; n = 73). Participants completed several QoL measures at baseline, posttest, and Year 1 and Year 2 follow-ups. Using linear mixed-effect models, no strong pattern of training effects across QoL outcomes was apparent, with small-magnitude, nonsignificant, between-group differences in depression, locus of control, and Medical Outcomes Study-HIV scales. In conclusion, despite prior work showing some transfer of SOP cognitive training improving QoL, that was not observed. Implications for research and practice are posited.
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Affiliation(s)
- David E Vance
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pariya L Fazeli
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Andres Azuero
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jennifer S Frank
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Virginia G Wadley
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - James L Raper
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Caitlin N Pope
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alexandra Jacob
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Karlene K Ball
- David E. Vance is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Pariya L. Fazeli is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Andres Azuero is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Jennifer S. Frank is an Instructor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Virginia G. Wadley is an Associate Professor (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- James L. Raper is a Professor and Director of the 1917 (HIV/AIDS) Clinic (retired), School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Caitlin N. Pope is an Assistant Professor, Department of Health, Behavior & Society, University of Kentucky, Lexington, Kentucky, USA
- Alexandra Jacob is a Medical Clinical Psychology Doctoral Student, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Karlene K. Ball is a Professor, Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Maass SWMC, Boerman LM, Brandenbarg D, Verhaak PFM, Maduro JH, de Bock GH, Berendsen AJ. Symptoms in long-term breast cancer survivors: A cross-sectional study in primary care. Breast 2020; 54:133-138. [PMID: 33035934 PMCID: PMC7554212 DOI: 10.1016/j.breast.2020.09.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 09/20/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022] Open
Abstract
Purpose Various long-term symptoms can manifest after breast cancer treatment, but we wanted to clarify whether these are more frequent among long-term breast cancer survivors than matched controls and if they are associated with certain diagnoses. Methods This was a cross-sectional, population-based study of 350 breast cancer survivors treated with chemo- and/or radiotherapy ≥5 years (median 10) after diagnosis and 350 women without cancer matched by age and primary care physician. All women completed a questionnaire enquiring about symptoms, underwent echocardiography to assess the left ventricle ejection fraction, and completed the Hospital Anxiety and Depression Scale. Cardiovascular diseases were diagnosed from primary care records. In a multivariable logistic regression analysis, symptoms were adjusted for the long-term effects and compared between cohorts and within the survivor group. Results Concentration difficulties, forgetfulness, dizziness, and nocturia were more frequent among breast cancer survivors compared with controls, but differences could not be explained by cardiac dysfunction, cardiovascular diseases, depression, or anxiety. Intermittent claudication and appetite loss were more frequent among breast cancer survivors than controls and associated with cardiac dysfunction, depression, and anxiety. Breast cancer survivors treated with chemotherapy with/without radiotherapy were at significantly higher odds of forgetfulness and nocturia, but significantly lower odds of dizziness, compared with breast cancer survivors treated with radiotherapy alone. Conclusions Intermittent claudication and appetite loss are common among breast cancer survivors and are associated with cardiac dysfunction and mood disorders. Other symptoms varied by whether the patient underwent chemotherapy with/without radiotherapy (forgetfulness and nocturia) radiotherapy alone (dizziness). Even 10 years after diagnosis, breast cancer survivors experience various long-term symptoms. Some symptoms are more common among breast cancer survivors than among controls without cancer. Not all symptoms are associated with known cardiovascular or psychological diagnoses. A symptom-specific approach may be appropriate. This study does not evaluate a causal relation.
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Affiliation(s)
- S W M C Maass
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, PO Box 196, 9700 AD, Groningen, the Netherlands.
| | - L M Boerman
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, PO Box 196, 9700 AD, Groningen, the Netherlands
| | - D Brandenbarg
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, PO Box 196, 9700 AD, Groningen, the Netherlands
| | - P F M Verhaak
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, PO Box 196, 9700 AD, Groningen, the Netherlands; NIVEL, Netherlands Institute of Health Services Research, Postbus 1568, 3500 BN, Utrecht, the Netherlands
| | - J H Maduro
- University of Groningen, University Medical Center Groningen, Department of Radiation Oncology, PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - G H de Bock
- University of Groningen, University Medical Center Groningen, Department of Epidemiology, PO Box 30.001, 9700 RB, Groningen, the Netherlands
| | - A J Berendsen
- University of Groningen, University Medical Center Groningen, Department of General Practice and Elderly Care Medicine, PO Box 196, 9700 AD, Groningen, the Netherlands
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