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Hu S, Ge J, Fang M, Yang J. Role of intergenerational connections in cognitive aging: Evidence from a Chinese longitudinal study. Front Public Health 2024; 12:1396620. [PMID: 39234093 PMCID: PMC11371578 DOI: 10.3389/fpubh.2024.1396620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 07/22/2024] [Indexed: 09/06/2024] Open
Abstract
Objective To explore the impact of intergenerational connections on cognitive function in middle-aged and older adults (45-60 years and over 60 years, respectively) and analyze the urban-rural and sex differences in the effects of intergenerational connections on cognitive function. Method Based on China Health and Retirement Longitudinal Study data (CHARLS), this study conducted ID matching for four waves of data from 2011, 2013, 2015, and 2018. Cognitive function was measured via Telephone Interview for Cognitive Status-modified (TICS-m), word recall, and imitation drawing. Using a combination of cross-sectional and longitudinal research, we constructed the cross-lagged panel model (CLPM) with a sample of 1,480 participants to explore the relationship between intergenerational connections and cognitive function. Results This study examines the impact of intergenerational connections on cognitive function in middle-aged (45-60 years) and older adults (over 60 years) using data from the CHARLS. It identifies urban-rural and sex differences, with notable effects among rural female participants. The frequency of meeting with one child negatively predicts cognitive function (β = -0.040, p = 0.041), and the frequency of communication with one child positively predicts cognitive function (β = 0.102, 0.068, 0.041, p < 0.001, p = 0.001, 0.045). Meanwhile, intergenerational connections with multiple children positively predicts cognitive function (β = 0.044, p = 0.031), (β = 0.128, 0.084, and 0.056, p < 0.001, 0.001, p = 0.008). There are urban-rural and sex differences in the effects of intergenerational connections on cognitive function; additionally, the effects of intergenerational connections on cognitive function are significant in rural female middle-aged and older adults. Discussion This study proposes the theory of skewed intergenerational support, which suggests that as middle-aged and older adults age, the responsibility for intergenerational support is skewed toward one child. This leads to conflicts between middle-aged and older parents and the child, which further affects cognitive function. In addition, this study put forward the boat-carrying theory of intergenerational relations and "to hold a bowl of water level" is the art of dealing with intergenerational relationships.
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Affiliation(s)
- Shanshan Hu
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Jingjing Ge
- College of Humanities and Management, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou, China
| | - Minglei Fang
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
| | - Jingjing Yang
- School of Public Health, Chongqing Medical University, Chongqing, China
- Research Center for Medicine and Social Development, Chongqing Medical University, Chongqing, China
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Wang LY, Hu SL, Yao ZF, Xue M, Lu ZQ, Xiao-ju Z, Ding Y. Correlation between cancer-related cognitive impairment and resting cerebral glucose metabolism in patients with ovarian cancer. Heliyon 2024; 10:e34106. [PMID: 39113970 PMCID: PMC11305194 DOI: 10.1016/j.heliyon.2024.e34106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 07/02/2024] [Accepted: 07/03/2024] [Indexed: 08/10/2024] Open
Abstract
Background An increasing number of research have applied neuroimaging techniques to explore the potential neurobiological mechanism of Cancer-related cognitive impairment (CRCI). Purpose To explore the correlation between resting brain glucose metabolism and CRCI using 18F-FDG PET/CT in ovarian cancer (OC) patients. Methods From December 2021 to March 2022, 38 patients with OC were selected as the study group, and 38 healthy women of the same age (±1 year) who underwent routine physical examination using PET/CT were selected as the control group. Patients received further assessment with the Montreal Cognitive Assessment Scale (MoCA) and Perceived Deficit Questionnaire (PDQ). Independent sample t-test and Spearman correlation were conducted for data analysis. Results The resting brain glucose metabolism in the OC group was significantly lower than in the healthy controls. 60.52 % patients had neuropsychological impairment and retrospective memory were the most serious perceived cognitive impairments. The resting brain glucose metabolism in OC patients did not significantly correlate with neuropsychological performance but had significant positive correlation with subjective cognitive evaluation. Discussion Resting glucose metabolism was low in OC patients and associated with subjective cognitive impairment but not objective neuropsychological test results. 18F-FDG PET/CT can be used to evaluate brain function in OC patients and provide reliable imaging indicators for early recognition of and intervention for changes in cognitive function.
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Affiliation(s)
- Li-ying Wang
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
- School of Nursing, Fudan University, Shanghai, 200032, China
| | - Si-long Hu
- Department of Nuclear Medicine, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhi-feng Yao
- Department of Nuclear Medicine, Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Mei Xue
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhen-qi Lu
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Zhang Xiao-ju
- Department of Nursing, Fudan University Shanghai Cancer Center, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, China
| | - Yan Ding
- Department of Nursing, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, 200090, China
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Chan YN, Betancur S, Conklin JL, Hirschey R, Piepmeier A, Foster M, Anderson RA, Bender CM, Bryant AL. Cognitive Function in Adults With Acute Myeloid Leukemia Treated With Chemotherapy: A Systematic Review. Cancer Nurs 2024; 47:121-131. [PMID: 36066343 PMCID: PMC10232672 DOI: 10.1097/ncc.0000000000001164] [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: 11/27/2022]
Abstract
BACKGROUND Chemotherapy is essential for treating acute myeloid leukemia (AML). Previous studies concluded that survivors of cancer who were treated with chemotherapy experience cognitive impairment. Therefore, it is important to understand cognitive function in survivors of AML. OBJECTIVE The aim of this study was to explore distributions and correlates of cognitive function, and prediction of cognitive function on other outcomes in adults with AML who were treated with chemotherapy. METHODS A health science librarian systematically searched PubMed, CINAHL, PsycINFO, and EMBASE databases. Two reviewers independently conducted the title, abstract, and full-text screening. Data were extracted and synthesized based on the aims of the review. RESULTS A total of 10 articles were included. Findings indicate that up to 62.2% of adults with AML experienced impaired cognitive function after starting chemotherapy. Three studies found cognitive function remained stable over time. Education and cytokines were potential correlates of cognitive function. Worse cognitive function may predict lower physical performance and higher mortality, although the results were inconsistent across studies. CONCLUSION Impaired cognitive function was observed in adults with AML who were treated with chemotherapy. However, no study used a validated subjective cognitive-function-specific patient-reported questionnaire, and previous studies focusing on cognitive function included relatively young samples. Hence, further research on cognitive function in older adults with AML is needed. IMPLICATIONS FOR PRACTICE Because of the high prevalence of cognitive impairment identified, it is important to screen cognitive function in adults with AML who are planning to receive chemotherapy to intervene and provide support earlier.
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Affiliation(s)
- Ya-Ning Chan
- Author Affiliations: School of Nursing (Dr Chan, Ms Betancur, and Drs Hirschey, Anderson, and Bryant), Health Sciences Library (Ms Conklin), and Lineberger Comprehensive Cancer Center (Drs Hirschey, Foster, and Bryant), University of North Carolina at Chapel Hill; Department of Exercise Science, Elon University (Dr Piepmeier), North Carolina; and School of Nursing, University of Pittsburgh (Dr Bender), Pennsylvania
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Moon C, Wilson RL, Gonzalo-Encabo P, Kang DW, Mithani S, Dieli-Conwright CM, Patel DI. Measurement of Cognitive Function in Exercise Oncology Studies in Patients Treated With Chemotherapy: A Scoping Review. Integr Cancer Ther 2024; 23:15347354241265349. [PMID: 39045709 PMCID: PMC11271141 DOI: 10.1177/15347354241265349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 06/07/2024] [Accepted: 06/14/2024] [Indexed: 07/25/2024] Open
Abstract
Cancer-associated cognitive deficits following chemotherapy have received increased attention in clinical research. Exercise has been shown to preserve cognitive function in cancer patients, though the overall effect is mixed. Here we present a scoping review of the published literature summarizing methods used to assess cognitive function in exercise oncology trials. Methods: PubMed, PsycINFO and CINAHL databases were searched using keywords "cognition," "cancer" OR "neoplasm" OR "tumor," "chemotherapy" and "exercise" OR "physical activity." Studies eligible for inclusion include prospective studies that were published in English in peer-reviewed journals that include a method of assessing cognitive function in adult cancer patients, in which an exercise modality or method of quantifying exercise habits was evident. Studies were excluded if they included a pediatric population, patients that were not diagnosed with cancer, or were systematic/narrative/scoping reviews, protocol papers or dissertation/theses. Results: A total of 29 studies met the inclusion criteria. In total, 29 unique assessments were used to evaluate cognitive function, including patient-reported outcomes (PROs; n = 8) and objective (n = 21) methods. More than half (n = 17) of included studies relied on PROs while 12 studies utilized objective measures of cognitive function Cognitive domains of the PROs were limited in scope, focusing on memory and attention/concentration while the objective measures were broader and inclusive of multiple domains. Conclusion: The results of this review indicate that mixed approaches to evaluating cognitive function in cancer patients pose a major limitation to understanding the role of exercise as an integrative approach. The evidence demonstrates a need for more uniform assessment of cognitive function in exercise oncology trials.
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Affiliation(s)
- Crisann Moon
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Rebekah L. Wilson
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Paola Gonzalo-Encabo
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dong-Woo Kang
- Dana-Farber Cancer Institute, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Sara Mithani
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | | | - Darpan I. Patel
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
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Ho MH, Cheung DST, Chan WL, Lin CC. Cognitive frailty in older cancer survivors and its association with health-related quality of life. Eur J Oncol Nurs 2023; 67:102426. [PMID: 37890442 DOI: 10.1016/j.ejon.2023.102426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/21/2023] [Accepted: 09/29/2023] [Indexed: 10/29/2023]
Abstract
PURPOSE This study aimed (1) to estimate the prevalence of cognitive frailty, (2) to identify factors associated with cognitive frailty and (3) to examine the association of cognitive frailty with health-related quality of life (HRQOL) in older cancer survivors. METHODS This was a cross-sectional study. Participants were aged 65 or above, diagnosed with cancer and had completed cancer treatment. Measures on physical frailty, cognitive functioning and HRQOL were administered. Multiple linear regression models were used to examine the association of cognitive frailty with HRQOL. RESULTS Among 293 recruited participants, 18.8% had a cognitive functioning decline, 8.9% were physically frail and 8.2% were cognitively frail. Regular exercise (OR = 0.383, p = .035) and shorter time since treatment completion were associated with less likelihood of cognitive frailty (OR = 1.004, p = .045). Cognitive frailty was significantly associated with global health status (β = -0.116; p = .044), physical functioning (β = -0.177; p = .002), social functioning (β = -0.123; p = .035) and fatigue symptoms (β = 0.212; p < .001) after adjusting for potential confounding variables. CONCLUSIONS Cognitive frailty, found in 8.2% of older cancer survivors, is associated with various dimensions of HRQOL. Longitudinal research examining the trajectory and impact of cognitive frailty on more diverse health outcomes in older cancer survivors is warranted. The findings improve service providers' knowledge of cognitive frailty in older cancer survivors and inform surveillance and care for geriatric cancer survivorship.
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Affiliation(s)
- Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong. https://twitter.com/DeniseCheung2
| | - Wing Lok Chan
- Department of Clinical Oncology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
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Vargo MM. Outcome Measures and Patient-Reported Metrics in Cancer Rehabilitation. Curr Oncol Rep 2023; 25:869-882. [PMID: 37148415 DOI: 10.1007/s11912-023-01412-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2023] [Indexed: 05/08/2023]
Abstract
PURPOSE OF REVIEW The current panorama of measurement tools for use in cancer rehabilitation is reviewed. For rehabilitation purposes, evaluating function is of the highest priority. RECENT FINDINGS From a patient-reported outcome (PRO) standpoint, SF-36 and EORTC-QLQ-C30 are in most common use in cancer rehabilitation research; these are quality of life measures that contain functional subdomains. Newer tools which are based on item response theory and have options for both computer assisted or short form (SF) administration, including the Patient-Reported Outcomes Measurement Information System (PROMIS) and Activity Measure for Post-acute Care (AMPAC) instruments, show increasing use, especially PROMIS Physical Function SF, and, recently, PROMIS Cancer Function Brief 3D, which has been validated in the cancer population, with domains of physical function, fatigue, and social participation, to track clinical rehabilitation outcomes. Evaluating objective measures of function in cancer patients is also crucial. Utilization of clinically feasible tools for cancer rehabilitation, to employ for both screening purposes and for monitoring of rehabilitation treatment efficacy, is an evolving area, much needed to promote further research and improved, consistent clinical care for cancer patients and survivors.
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Affiliation(s)
- Mary M Vargo
- Physical Medicine and Rehabilitation, MetroHealth Medical Center, Case Western Reserve University, 4229 Pearl Road, Cleveland, OH, 44109, USA.
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Takemura N, Ho MH, Cheung DST, Lin CC. Factors associated with perceived cognitive impairment in patients with advanced lung cancer: a cross-sectional analysis. Support Care Cancer 2022; 30:9607-9614. [PMID: 36178636 DOI: 10.1007/s00520-022-07377-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 09/25/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE Perceived cognitive impairment refers to cognitive dysfunction that particularly involves impairment in working or short-term memory, and inattention. This study aimed to identify factors associated with perceived cognitive impairment in patients with advanced lung cancer. METHODS This cross-sectional analysis used pooled data from a prospective, ongoing randomized controlled trial examining the effectiveness of exercise in patients with advanced lung cancer (Trial Registration: NCT04119778). Patients diagnosed with stage IIIB or IV non-small cell lung cancer were recruited from three public hospitals in Hong Kong between December 2018 and December 2021. Demographics, daily step count, sleep quality, fatigue, depression, anxiety, and perceived cognitive impairment were included in the analyses. Multivariate logistic regression analysis was used to determine the most critical risk factors associated with perceived cognitive impairments in attention and memory. RESULTS A total of 226 patients were included and analyzed, 35.4% of patients had perceived attention impairment and 58.4% had perceived memory impairment. The daily step count (adjusted odds ratio [aOR] = 0.496; confidence interval [CI] = 0.258-0.954), fatigue (aOR = 1.342; CI = 1.903-1.648), and anxiety (aOR = 1.179; CI = 1.042-1.335) were associated with a significantly increased risk of perceived attention impairment, while anxiety (aOR = 1.126; CI = 1.008-1.257) was identified as the most significant factor for perceived memory impairment. CONCLUSION The findings of this study can inform the design of effective interventions to reduce perceived cognitive impairment and promote the quality of life and well-being of patients with advanced lung cancer.
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Affiliation(s)
- Naomi Takemura
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Mu-Hsing Ho
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Denise Shuk Ting Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong
| | - Chia-Chin Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 5/F, Academic Building, 3 Sassoon Road, Pokfulam, Hong Kong.
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Oppegaard KR, Armstrong TS, Anguera JA, Kober KM, Debr LK, Laister RC, Saligan LN, Ayala AP, Kuruvilla J, Alm MW, Byker WH, Miaskowski C, Mayo SJ. Blood-Based Biomarkers of Cancer-Related Cognitive Impairment in Non-Central Nervous System Cancer: A Scoping Review. Crit Rev Oncol Hematol 2022; 180:103822. [PMID: 36152911 DOI: 10.1016/j.critrevonc.2022.103822] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 11/24/2022] Open
Abstract
This scoping review was designed to synthesize the extant literature on associations between subjective and/or objective measures of cancer-related cognitive impairment (CRCI) and blood-based biomarkers in adults with non-central nervous system cancers. The literature search was done for studies published from the start of each database searched (i.e., MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, grey literature) through to October 20, 2021. A total of 95 studies are included in this review. Of note, a wide variety of biomarkers were evaluated. Most studies evaluated patients with breast cancer. A variety of cognitive assessment measures were used. The most consistent significant findings were with various subjective and objective measures of CRCI and levels of interleukin-6 and tumor necrosis factor. Overall, biomarker research is in an exploratory phase. However, this review synthesizes findings and proposes directions for future research.
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Affiliation(s)
- Kate R Oppegaard
- University of California San Francisco, School of Nursing, Department of Physiological Nursing, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, USA
| | - Joaquin A Anguera
- University of California San Francisco, Department of Neurology and Psychiatry, USA
| | - Kord M Kober
- University of California San Francisco, School of Nursing, Department of Physiological Nursing, USA
| | - Lynch Kelly Debr
- University of Florida, College of Nursing, USA; University of Florida Health Cancer Center, USA
| | - Rob C Laister
- Princess Margaret Health Center, University Health Network, Canada
| | - Leorey N Saligan
- Symptoms Biology Unit, Division of Intramural Research, National Institutes of Health, USA
| | | | - John Kuruvilla
- Princess Margaret Health Center, University Health Network, Canada
| | - Mark W Alm
- Toronto General Hospital, University Health Network, Canada
| | | | - Christine Miaskowski
- University of California San Francisco, School of Medicine, Department of Anesthesia and Perioperative Care, USA
| | - Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada.
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Coro DG, Hutchinson AD, Banks S, Coates AM. Dietary Drivers and Challenges of Australian Breast Cancer Survivors: A Qualitative Study. WOMEN'S HEALTH REPORTS 2022; 3:563-572. [PMID: 35814608 PMCID: PMC9258797 DOI: 10.1089/whr.2021.0133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/05/2022] [Indexed: 11/19/2022]
Abstract
Purpose: Cancer survivors often make long-term dietary changes, and nutrition is important for survivorship outcomes. Many survivors experience persisting cognitive difficulties, which can impact health behaviors. This study aimed to identify perceived drivers of eating habit changes, and the barriers to making intentional dietary changes, among breast cancer survivors with persisting self-reported cancer-related cognitive impairment. Materials and Methods: A qualitative framework explored survivors' perceptions of dietary habit changes. Thirteen Australian breast cancer survivors (M.time since diagnosis: 23.6 months, standard deviation [SD] 15.3; M.time since completing primary treatment: 14.7 months, SD 15.3) completed semistructured interviews. Questions related to dietary changes since diagnosis and treatment. Major themes were identified from interview transcripts using thematic analysis. Results: While most individuals perceived their diet to be broadly similar to prediagnosis, several changes to diet and eating habits were identified, which were often meaningful to these survivors. Themes relating to survivors' eating habit changes included the following: (1) meal timing and frequency shifts, (2) more plant-based eating, and (3) less variety and more convenience. Changes in eating habits were attributed to the following: (1) persisting treatment-related changes, (2) help and support from others, (3) old treatment habits, (4) preventative health and self-care, and (5) changes to work schedule. Barriers to making intentional dietary changes included the following: (1) too much time and effort, (2) food cravings and enjoyment, and (3) lacking dietary ideas and resources. Conclusions: Many survivors reported long-term changes in dietary habits, some of which align with current recommendations. Causes of dietary habit changes, and barriers to engaging in healthier dietary habits, involved multiple biopsychosocial elements. Additional resources or strategies that assist navigating survivorship challenges and their effects on dietary habits are needed. Future studies should explore whether post-treatment nutritional review with a qualified dietary health professional is helpful for survivors who experience long-term cancer-related cognitive impairment.
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Affiliation(s)
- Daniel G. Coro
- Behaviour-Brain-Body Research Centre, UniSA Justice & Society, University of South Australia, Adelaide, Australia
| | - Amanda D. Hutchinson
- Behaviour-Brain-Body Research Centre, UniSA Justice & Society, University of South Australia, Adelaide, Australia
| | - Siobhan Banks
- Behaviour-Brain-Body Research Centre, UniSA Justice & Society, University of South Australia, Adelaide, Australia
| | - Alison M. Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), UniSA Allied Health & Human Performance, University of South Australia, Adelaide, Australia
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Araújo N, Lopes-Conceição L, Morais S, Fontes F, Dias T, Cruz VT, Ruano L, Pereira S, Lunet N. Interchangeability of two versions of the Montreal Cognitive Assessment for the longitudinal evaluation of patients with breast cancer. Support Care Cancer 2021; 30:2639-2647. [PMID: 34817694 DOI: 10.1007/s00520-021-06702-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 11/15/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE The cognitive performance of patients with breast cancer (BCa) may be affected by cancer and its treatments. The Montreal Cognitive Assessment (MoCA) is a widely used cognitive impairment screening tool, but practice effects must be considered for longitudinal assessments. Since learning effects could be overcome through the alternate use of two versions of the MoCA, we aimed to explore their interchangeability by comparing their overall, and domain- and task-specific, scores among patients with BCa. METHODS BCa patients from the NEON-BC cohort were evaluated with the MoCA, version 7.1, after diagnosis and after 1 year. At the 3-year follow-up (n = 422), the 7.1 and 7.3 versions were applied at the beginning and at the end (approximately 1 h later) of this evaluation, respectively. Agreements between versions, regarding total, sub-domain, and task scores, were assessed using Bland-Altman plots and intraclass correlation coefficients (ICC). RESULTS The mean total scores were not statistically different between versions and the ICC was 0.890. The Bland-Altman limits of agreement were - 3.70 to 3.88. For women with midrange scores, total scores were significantly higher in version 7.1. There were significant differences in the percentage of correct answers in 7 out of 12 tasks, being the highest for the copy of a geometric figure (more than twofold higher with version 7.3). In version 7.1, the language and memory domains presented higher scores and lower visuospatial ability. CONCLUSION Despite similar overall scores being obtained with the two versions of the MoCA, there were item-specific differences that may compromise their interchangeable use.
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Affiliation(s)
- Natália Araújo
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal
| | | | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Filipa Fontes
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Teresa Dias
- Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Vítor Tedim Cruz
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Senhora da Hora, Portugal
| | - Luís Ruano
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Centro Hospitalar Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - Susana Pereira
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal.,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal.,Instituto Português de Oncologia do Porto, Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal. .,Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal. .,Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
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11
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Nekhlyudov L, Campbell GB, Schmitz KH, Brooks GA, Kumar AJ, Ganz PA, Von Ah D. Cancer-related impairments and functional limitations among long-term cancer survivors: Gaps and opportunities for clinical practice. Cancer 2021; 128:222-229. [PMID: 34529268 PMCID: PMC9292035 DOI: 10.1002/cncr.33913] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/27/2021] [Accepted: 08/27/2021] [Indexed: 12/20/2022]
Abstract
This commentary provides a concise overview of the epidemiology of cancer survivorship and work, common functional limitations experienced by cancer survivors, and evidence‐based recommendations for interventions available to improve function. It also describes the US Social Security Administration's disability claims process, its eligibility requirements, and barriers for long‐term survivors in securing approval for disability claims, and offers insights for practicing clinicians in holistically addressing functional limitations in practice.
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Affiliation(s)
- Larissa Nekhlyudov
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Grace B Campbell
- Duquesne University School of Nursing, Pittsburgh, Pennsylvania.,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Kathryn H Schmitz
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania
| | - Gabriel A Brooks
- Norris Cotton Cancer Center, Geisel School of Medicine, Lebanon, New Hampshire
| | - Anita J Kumar
- Department of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Patricia A Ganz
- School of Medicine, University of California Los Angeles, Los Angeles, California.,Department of Health Policy and Management, School of Public Health, University of California Los Angeles, Los Angeles, California.,Jonsson Comprehensive Cancer Center, University of California Los Angeles, Los Angeles, California
| | - Diane Von Ah
- College of Nursing, Ohio State University, Columbus, Ohio
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12
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Cancer-Related Cognitive Impairment or “Chemobrain:” Emerging Assessments, Treatments, and Targets for Intervention. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2021. [DOI: 10.1007/s40141-021-00319-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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13
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Han K, Kim M, Kim E, Park Y, Kwon O, Kim A, Park H, Park Y, Cho JH, Kim J, Lee J. Moxibustion for treating cancer-related fatigue: A multicenter, assessor-blinded, randomized controlled clinical trial. Cancer Med 2021; 10:4721-4733. [PMID: 34189864 PMCID: PMC8290232 DOI: 10.1002/cam4.4020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/11/2021] [Accepted: 05/04/2021] [Indexed: 12/17/2022] Open
Abstract
Cancer-related fatigue (CRF) is one of the most common chronic symptoms experienced by cancer patients. As moxibustion is a popular traditional therapy for managing fatigue, it can be an alternative strategy to treat CRF as well. Therefore, we rigorously designed a full-scale, multicenter, assessor-blinded, randomized controlled trial to evaluate the efficacy and safety of moxibustion treatment for CRF. Ninety-six subjects suffering from CRF were recruited and randomly assigned to moxibustion group, sham moxibustion group, or usual care group. Both the moxibustion group and the sham group received moxibustion treatment for 8 weeks and the usual care group did not. Brief fatigue inventory (BFI) score and Functional Assessment of Cancer Therapy-Fatigue score were used to assess CRF at baseline and weeks 5, 9, and 13. Questionnaires for the assessment of cognitive impairment, quality of life, and Cold-Heat and Deficiency-Excess patterns were also evaluated. BFI scores significantly decreased in moxibustion group compared to the usual care group (mean difference of -1.92, p < 0.001 at week 9 and mean difference of -2.36, p < 0.001 at week 13). Although the sham group also showed significant improvement during the treatment period, only the moxibustion group showed improvement after 4 weeks of follow-up period (mean difference of -1.06, p < 0.001). There were no serious adverse events. Our findings confirmed the efficacy and safety of moxibustion for CRF compared to usual care. We also found that moxibustion has a prolonged treatment effect during 4 weeks of follow-up period.
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Affiliation(s)
- Kyungsun Han
- Clinical Medicine DivisionKorea Institute of Oriental MedicineDaejeonRepublic of Korea
| | - Mikyung Kim
- Department of Internal Medicine, College of Korean MedicineSangji UniversityWonjuRepublic of Korea
| | - Eun‐Jung Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean MedicineDongguk UniversityGyeongjuRepublic of Korea
| | - Yeon‐Cheol Park
- Department of Acupuncture and Moxibustion MedicineKyung Hee University Hospital at GangdongSeoulRepublic of Korea
| | - Ojin Kwon
- Clinical Medicine DivisionKorea Institute of Oriental MedicineDaejeonRepublic of Korea
| | - Ae‐Ran Kim
- Clinical Medicine DivisionKorea Institute of Oriental MedicineDaejeonRepublic of Korea
| | - Hyo‐Ju Park
- Clinical Medicine DivisionKorea Institute of Oriental MedicineDaejeonRepublic of Korea
| | - Yang‐Chun Park
- Department of Internal Medicine, College of Korean MedicineDaejeon UniversityDaejeonRepublic of Korea
| | - Jung Hyo Cho
- Department of Internal Medicine, College of Korean MedicineDaejeon UniversityDaejeonRepublic of Korea
| | - Joo‐Hee Kim
- Department of Acupuncture and Moxibustion Medicine, College of Korean MedicineSangji UniversityGangwon‐doRepublic of Korea
- Research Institute of Korean MedicineSangji UniversityGangwon‐doRepublic of Korea
| | - Jun‐Hwan Lee
- Clinical Medicine DivisionKorea Institute of Oriental MedicineDaejeonRepublic of Korea
- Korean Medicine Life ScienceUniversity of Science and Technology (UST), Campus of Korea Institute of Oriental MedicineDaejeonRepublic of Korea
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14
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Araújo N, Severo M, Lopes-Conceição L, Fontes F, Dias T, Branco M, Morais S, Cruz VT, Ruano L, Pereira S, Lunet N. Trajectories of cognitive performance over five years in a prospective cohort of patients with breast cancer (NEON-BC). Breast 2021; 58:130-137. [PMID: 34023557 PMCID: PMC8165446 DOI: 10.1016/j.breast.2021.05.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/08/2021] [Accepted: 05/13/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose To identify trajectories of cognitive performance up to five years since diagnosis and their predictors, in a cohort of patients with breast cancer (BCa). Methods A total of 464 women with BCa admitted to the Portuguese Institute of Oncology, Porto, during 2012, were evaluated with the Montreal Cognitive Assessment (MoCA) before any treatment, and after one, three and five years. Probable cognitive impairment (PCI) at baseline was defined based on normative age- and education-specific reference values. Mclust was used to define MoCA trajectories. Receiver Operating Characteristic curves were used to assess the predictive accuracy for cognitive trajectories. Results Two trajectories were identified, one with higher scores and increasing overtime, and the other, including 25.9% of the participants, showing a continuous decline. To further characterize each trajectory, participants were also classified as scoring above or below the median baseline MoCA scores. This resulted in four groups: 1) highest baseline scores, stable overtime (0.0% with PCI); 2) lowest baseline scores (29.5% with PCI); 3) mid-range scores at baseline, increasing overtime (10.5% with PCI); 4) mid-range scores at baseline, decreasing overtime (0.0% with PCI). Adding the change in MoCA during the first year to baseline variables significantly increased the accuracy to predict the downward trajectory (area under the curve [AUC] = 0.732 vs. AUC = 0.841, P < 0.001). Conclusion Four groups of patients with BCa with different cognitive performance trends were identified. The assessment of cognitive performance before treatments and after one year allows for the identification of patients more likely to have cognitive decline in the long term. 5-year cognitive trajectories since diagnosis of breast cancer were identified. 25.9% of breast cancer survivors had a declining cognitive trajectory. Cognitive performance during the 1st year predicted the 5-year trajectory.
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Affiliation(s)
- Natália Araújo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal
| | - Milton Severo
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Luisa Lopes-Conceição
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Instituto Português de Oncologia do Porto Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Filipa Fontes
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal; Instituto Português de Oncologia do Porto Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Teresa Dias
- Instituto Português de Oncologia do Porto Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Mariana Branco
- Centro Hospitalar de Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal
| | - Samantha Morais
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal
| | - Vítor Tedim Cruz
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Rua Dr. Eduardo Torres, 4464-513, Senhora da Hora, Portugal
| | - Luis Ruano
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal; Centro Hospitalar de Entre Douro e Vouga, Rua Dr. Cândido de Pinho, 4520-211, Santa Maria da Feira, Portugal
| | - Susana Pereira
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Instituto Português de Oncologia do Porto Francisco Gentil, Rua Dr. António Bernardino de Almeida, 4200-072, Porto, Portugal
| | - Nuno Lunet
- EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, 135, 4050-600, Porto, Portugal; Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Rua das Taipas, 135, 4050-600, Porto, Portugal; Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina da Universidade do Porto, Alameda Professor Hernâni Monteiro, 4200-319, Porto, Portugal.
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15
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Navarrete-Reyes AP, Animas-Mijangos K, Gómez-Camacho J, Juárez-Carrillo Y, Torres-Pérez AC, Cataneo-Piña DJ, Negrete-Najar JP, Soto-Perez-de-Celis E. Geriatric principles for patients with cancer. GERIATRICS, GERONTOLOGY AND AGING 2021. [DOI: 10.5327/z2447-212320212100009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Cancer is primarily a disease of older persons. Given the heterogeneity of aging, physiological age, rather than chronological age, better expresses the cumulative effect of environmental, medical, and psychosocial stressors, which modifies life expectancy. Comprehensive geriatric assessment, a tool that helps ascertain the physiological age of older individuals, is the gold standard for assessing older adults with cancer. Several international organizations recommend using the geriatric assessment domains to identify unrecognized health problems that can interfere with treatment and predict adverse health-related outcomes, aiding complex treatment decision making. More recently, it has been shown that geriatric assessment-guided interventions improve quality of life and mitigate treatment toxicity without compromising survival. In this review, we discuss the role of comprehensive geriatric assessment in cancer care for older adults and provide the reader with useful information to assess potential treatment risks and benefits, anticipate complications, and plan interventions to better care for older people with cancer.
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16
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Mayo SJ, Lustberg M, M Dhillon H, Nakamura ZM, Allen DH, Von Ah D, C Janelsins M, Chan A, Olson K, Tan CJ, Toh YL, Oh J, Grech L, Cheung YT, Subbiah IM, Petranovic D, D'Olimpio J, Gobbo M, Koeppen S, Loprinzi CL, Pang L, Shinde S, Ntukidem O, Peters KB. Cancer-related cognitive impairment in patients with non-central nervous system malignancies: an overview for oncology providers from the MASCC Neurological Complications Study Group. Support Care Cancer 2020; 29:2821-2840. [PMID: 33231809 DOI: 10.1007/s00520-020-05860-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 10/26/2020] [Indexed: 02/07/2023]
Abstract
Cancer-related cognitive impairment (CRCI) is commonly experienced by individuals with non-central nervous system cancers throughout the disease and treatment trajectory. CRCI can have a substantial impact on the functional ability and quality of life of patients and their families. To mitigate the impact, oncology providers must know how to identify, assess, and educate patients and caregivers. The objective of this review is to provide oncology clinicians with an overview of CRCI in the context of adults with non-central nervous system cancers, with a particular focus on current approaches in its identification, assessment, and management.
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Affiliation(s)
- Samantha J Mayo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada. .,Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
| | - Maryam Lustberg
- The Ohio State Comprehensive Cancer Center, Columbus, OH, USA
| | | | - Zev M Nakamura
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Diane Von Ah
- Indiana University School of Nursing, Indianapolis, IN, USA
| | - Michelle C Janelsins
- Department of Surgery, University of Rochester Medical Center, Rochester, NY, USA.,Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA.,Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA
| | | | - Karin Olson
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Chia Jie Tan
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yi Long Toh
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jeong Oh
- Peter MacCallum Cancer Centre, Parkville, Australia
| | - Lisa Grech
- National University of Singapore, Singapore, Singapore.,Swinburne University, Hawthorn, Australia.,University of Melbourne, Parkville, Australia.,Monash University, Clayton, Australia
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | | | - Duska Petranovic
- Clinical Hospital Center Rijeka, Faculty of Medicine, University of Rijeka, Rijeka, Croatia
| | - James D'Olimpio
- Monter Cancer Center, Northwell Cancer Institute, Lake Success, NY, USA
| | - Margherita Gobbo
- Division of Oral Medicine and Pathology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,Unit of Oral and Maxillofacial Surgery, Ca Foncello Hospital, Treviso, Italy
| | - Susanne Koeppen
- LVR-Klinikum Essen, University of Duisburg-Essen, Essen, Germany
| | | | | | | | | | - Katherine B Peters
- The Preston Robert Tisch Brain Tumor Center, Duke University, Durham, NC, USA
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17
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Eggen AC, Reyners AKL, Shen G, Bosma I, Jalving M, Leighl NB, Liu G, Richard NM, Mah K, Shultz DB, Edelstein K, Rodin G. Death Anxiety in Patients With Metastatic Non-Small Cell Lung Cancer With and Without Brain Metastases. J Pain Symptom Manage 2020; 60:422-429.e1. [PMID: 32145337 DOI: 10.1016/j.jpainsymman.2020.02.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/20/2020] [Accepted: 02/23/2020] [Indexed: 12/16/2022]
Abstract
CONTEXT Death anxiety is common in patients with metastatic cancer, but its relationship to brain metastases and cognitive decline is unknown. Early identification of death anxiety and its determinants allows proactive interventions to be offered to those in need. OBJECTIVES To identify psychological, physical, and disease-related (including brain metastases and cognitive impairment) factors associated with death anxiety in metastatic non-small cell lung cancer (mNSCLC) patients. METHODS A cross-sectional pilot study with mNSCLC outpatients completing standardized neuropsychological tests and validated questionnaires measuring death anxiety, cognitive concerns, illness intrusiveness, depression, demoralization, self-esteem, and common cancer symptoms. We constructed a composite for objective cognitive function (mean neuropsychological tests z-scores). RESULTS Study measures were completed by 78 patients (50% females; median age 62 years [range 37-82]). Median time since mNSCLC diagnosis was 11 months (range 0-89); 53% had brain metastases. At least moderate death anxiety was reported by 43% (n = 33). Objective cognitive impairment was present in 41% (n = 32) and perceived cognitive impairment in 27% (n = 21). Death anxiety, objective, and perceived cognitive impairment did not significantly differ between patients with and without brain metastases. In univariate analysis, death anxiety was associated with demoralization, depression, self-esteem, illness intrusiveness, common physical cancer symptoms, and perceived cognitive impairment. In multivariate analysis, demoralization (P < 0.001) and illness intrusiveness (P = 0.001) were associated with death anxiety. CONCLUSION Death anxiety and brain metastases are common in patients with mNSCLC but not necessarily linked. The association of death anxiety with both demoralization and illness intrusiveness highlights the importance of integrated psychological and symptom management. Further research is needed on the psychological impact of brain metastases.
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Affiliation(s)
- Annemarie C Eggen
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands; Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Anna K L Reyners
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Gerald Shen
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Ingeborg Bosma
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Mathilde Jalving
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Natasha B Leighl
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Geoffrey Liu
- Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Nadine M Richard
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Kenneth Mah
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - David B Shultz
- Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Kim Edelstein
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Gary Rodin
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
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18
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Cognitive Impairment in Brain Tumor Survivors: Emerging Evidence to Identify Associated Fall Risk. REHABILITATION ONCOLOGY 2020. [DOI: 10.1097/01.reo.0000000000000221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Nakamura ZM, Deal AM, Nyrop KA, Damone EM, Muss HB. Associations of functional, psychosocial, and medical factors with cognitive impairment in older, chemotherapy naïve patients with early breast cancer. Psychooncology 2020; 29:1366-1369. [PMID: 32458438 DOI: 10.1002/pon.5433] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 12/22/2022]
Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Allison M Deal
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kirsten A Nyrop
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Emily M Damone
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hyman B Muss
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Division of Hematology/Oncology, Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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20
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Padgett LS, Van Dyk K, Kelly NC, Newman R, Hite S, Asher A. Addressing Cancer-Related Cognitive Impairment in Cancer Survivorship. ACTA ACUST UNITED AC 2020. [DOI: 10.1080/10463356.2020.1692601] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Piai V, Prins JB, Verdonck-de Leeuw IM, Leemans CR, Terhaard CHJ, Langendijk JA, Baatenburg de Jong RJ, Smit JH, Takes RP, Kessels RPC. Assessment of Neurocognitive Impairment and Speech Functioning Before Head and Neck Cancer Treatment. JAMA Otolaryngol Head Neck Surg 2019; 145:251-257. [PMID: 30676629 PMCID: PMC6439757 DOI: 10.1001/jamaoto.2018.3981] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/24/2018] [Indexed: 12/19/2022]
Abstract
Importance Head and neck cancer (HNC) and its treatment may negatively alter neurocognitive and speech functioning. However, the prevalence of neurocognitive impairment among patients with HNC before treatment is poorly studied, and the association between neurocognitive and speech functioning is unknown, which hampers good interpretability of the effect of HNC treatment on neurocognitive and speech function. Objectives To document neurocognitive functioning in patients with HNC before treatment and to investigate the association between neurocognitive and speech functioning. Design, Setting, and Participants Prospective cohort study of newly diagnosed patients with HNC before treatment using a large sample obtained in a nationwide, multicenter setting (Netherlands Quality of Life and Biomedical Cohort Study in Head and Neck Cancer [NET-QUBIC] project). Main Outcome and Measures Objective neuropsychological measures of delayed recall, letter fluency, and executive functioning, as well as patient-reported outcome measures on neurocognitive speech and functioning, were collected before treatment. Results In total, 254 patients with HNC participated (71.7% male), with a mean (SD) age of 62 (10) years. The response rate ranged from 81.9% (208 of 254) to 84.6% (215 of 254). Objective neurocognitive measures indicated that 4.7% (10 of 212) to 15.0% (32 of 214) of patients were initially seen with moderate to severe cognitive impairment. Mild to moderate impairment was found in 12.3% (26 of 212) to 26.2% (56 of 214) of patients. The most altered domains were delayed recall and letter fluency. Seven percent (15 of 208) of the patients reported high levels of everyday neurocognitive failure, and 42.6% (89 of 209) reported speech problems. Objective neurocognitive function was not significantly associated with patient-reported neurocognitive or speech functioning, but the results from patient-reported outcome measures were significantly correlated. Conclusions and Relevance Results of this study demonstrate a high prevalence of impaired speech functioning among patients with HNC before treatment, which is in line with previous findings. A novel finding is that neurocognitive impairment is also highly prevalent as objectively measured and as self-perceived. Understanding the reason why patients with HNC are initially seen with neurocognitive impairment before the start of treatment is important because this impairment may complicate patient-clinician interaction and alter treatment adherence and because treatment itself may further worsen cognitive functioning. In addition, low self-perceived neurocognitive and speech functioning before treatment may decrease a patient's confidence in communicative participation and perceived quality of life. Disentangling the associations between objective and patient-reported neurocognitive and speech functions is an important area for future research.
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Affiliation(s)
- Vitória Piai
- Radboud University Medical Center, Donders Centre for Medical Neuroscience, Department of Medical Psychology, Nijmegen, the Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Nijmegen, the Netherlands
| | - Judith B. Prins
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Medical Psychology, Nijmegen, the Netherlands
| | - Irma M. Verdonck-de Leeuw
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology–Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam, the Netherlands
- Vrije Universiteit, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
| | - C. René Leemans
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Otolaryngology–Head and Neck Surgery, Cancer Center Amsterdam, Amsterdam, the Netherlands
| | - Chris H. J. Terhaard
- Vrije Universiteit, Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Amsterdam, the Netherlands
- Department of Radiotherapy, University Medical Center, Utrecht, the Netherlands
| | - Johannes A. Langendijk
- Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Robert J. Baatenburg de Jong
- Department of Otolaryngology and Head and Neck Surgery, Erasmus Cancer Institute, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Johannes H. Smit
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health, Amsterdam, the Netherlands
| | - Robert P. Takes
- Radboud University Medical Center, Radboud Institute for Health Sciences, Department of Otorhinolaryngology and Head and Neck Surgery, Nijmegen, the Netherlands
| | - Roy P. C. Kessels
- Radboud University Medical Center, Donders Centre for Medical Neuroscience, Department of Medical Psychology, Nijmegen, the Netherlands
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Nijmegen, the Netherlands
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22
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Nakamura ZM, Nash RP, Quillen LJ, Richardson DR, McCall RC, Park EM. Psychiatric Care in Hematopoietic Stem Cell Transplantation. PSYCHOSOMATICS 2019; 60:227-237. [PMID: 30733043 DOI: 10.1016/j.psym.2019.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Patients with cancer frequently experience neuropsychiatric symptoms due to their medical illness or its treatment. In recent decades, psychiatrists have become increasingly involved in the care of patients with cancer. However, psychiatrists may be less familiar with hematopoietic stem cell transplantation (HSCT), a distinct cancer treatment modality associated with multiple neuropsychiatric sequelae. OBJECTIVE To provide an overview of HSCT, and describe the prevalence, impact, risk factors, and suggested management of psychiatric consequences of HSCT. METHODS We performed literature searches in PubMed and PsychInfo to identify articles describing neuropsychiatric symptoms, including depression, anxiety, distress, post-traumatic stress disorder, delirium and cognitive impairment, resulting from HSCT in adults. Those articles most relevant to this manuscript were included. RESULTS Psychiatrists may be involved in the treatment of patients before, during, or after inpatient hospitalization for HSCT. Each phase of treatment introduces unique stressors that may lead to or exacerbate psychiatric disorders. Appropriate management requires evaluation of HSCT-related medications, an understanding of the impact of complications from HSCT, and consideration of how the patient's underlying medical condition should influence psychiatric recommendations. CONCLUSION To optimize patient outcomes, consulting psychiatrists should be familiar with the basic principles of HSCT, and the neuropsychiatric sequelae that may result from treatment. Further research is needed to identify strategies to manage psychiatric complications in this unique population.
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Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina - Chapel Hill, Chapel Hill, NC.
| | - Rebekah P Nash
- Department of Psychiatry, University of North Carolina - Chapel Hill, Chapel Hill, NC
| | - Laura J Quillen
- Department of Psychiatry, University of North Carolina - Chapel Hill, Chapel Hill, NC
| | - Daniel R Richardson
- Lineberger Comprehensive Cancer Center, University of North Carolina - Chapel Hill, Chapel Hill, NC; The Cecil G. Sheps Center for Health Services Research, University of North Carolina - Chapel Hill, Chapel Hill, NC
| | - Rebecca C McCall
- Health Sciences Library, University of North Carolina - Chapel Hill, Chapel Hill, NC
| | - Eliza M Park
- Department of Psychiatry, University of North Carolina - Chapel Hill, Chapel Hill, NC; Lineberger Comprehensive Cancer Center, University of North Carolina - Chapel Hill, Chapel Hill, NC; Department of Medicine, University of North Carolina - Chapel Hill, Chapel Hill, NC
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23
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Lycke M, Lefebvre T, Pottel L, Pottel H, Ketelaars L, Stellamans K, Eygen KV, Vergauwe P, Werbrouck P, Goethals L, Schofield P, Boterberg T, Debruyne PR. The distress thermometer predicts subjective, but not objective, cognitive complaints six months after treatment initiation in cancer patients. J Psychosoc Oncol 2017; 35:741-757. [DOI: 10.1080/07347332.2017.1365798] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michelle Lycke
- Division of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Tessa Lefebvre
- Division of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Lies Pottel
- Division of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Hans Pottel
- Department of Public Health and Primary Care @ Kulak, Catholic University Leuven Kulak, Kortrijk, Belgium
| | - Lore Ketelaars
- Department of Neuropsychology, General Hospital Groeninge, Kortrijk, Belgium
| | - Karin Stellamans
- Division of Radiotherapy, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Koen Van Eygen
- Division of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
- Division of Haematology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Philippe Vergauwe
- Department of Gastro-Enterology, General Hospital Groeninge, Kortrijk, Belgium
| | - Patrick Werbrouck
- Department of Urology, General Hospital Groeninge, Kortrijk, Belgium
| | - Laurence Goethals
- Division of Radiotherapy, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
| | - Patricia Schofield
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
| | - Tom Boterberg
- Department of Radiation Oncology and Experimental Cancer Research, Ghent University, Ghent, Belgium
| | - Philip R. Debruyne
- Division of Medical Oncology, Cancer Centre, General Hospital Groeninge, Kortrijk, Belgium
- Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK
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