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Wang L, Ding Y, Zhang Y, Chen Y, Xue M, Wang X. The association between neuropsychological impairment, self-perceived cognitive deficit, symptoms, and health related quality of life in newly diagnosed ovarian cancer patients. Asia Pac J Oncol Nurs 2024; 11:100447. [PMID: 38798881 PMCID: PMC11127092 DOI: 10.1016/j.apjon.2024.100447] [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: 01/20/2024] [Accepted: 03/18/2024] [Indexed: 05/29/2024] Open
Abstract
Objective To assess cognitive function in patients newly diagnosed with ovarian cancer (OC) before treatment and explore the relationship between neuropsychological impairment, self-perceived cognitive deficit, symptoms, and health-related quality of life in them. Methods From May 2021 to February 2022, 105 women newly diagnosed with OC were enrolled in the Cancer Center of Fudan University, Shanghai, China. Objective and subjective cognitive functions were assessed using the Montreal Cognitive Assessment (MoCA) scale and Perceptual Deficits Questionnaire (PDQ). Symptoms and quality of life were evaluated using the Memorial Symptom Assessment Scale (MSAS) and Functional Assessment of Cancer Therapy-Ovarian Cancer (FACT-O), respectively. Results This study included 105 newly diagnosed OC patients, with an average age of 49.73 (±8.48) years. Of these, 72.38% had impaired neuropsychological test scores, especially in delayed recall, abstraction, and visuospatial/executive function. Retrospective, and prospective memory were the most serious perceived deficits. The results of the MoCA test were not associated with PDQ (Rs = -0.180, P = 0.067) and significantly correlated with the distress index, physiological and total scores of the MSAS, and emotional well- being of the FACT-O. The PDQ positively correlated with all MSAS dimensions but not with the FACT-O. Conclusion The incidence of neuropsychological impairment in patients newly diagnosed with OC was high, with no association with self-perceived cognitive deficits. It is recommended that healthcare providers include cognitive impairment in symptom management in this population, who may benefit from early assessment, prevention, and intervention.
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Affiliation(s)
- Liying Wang
- School of Nursing, Fudan University, Shanghai, China
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yan Ding
- School of Nursing, Fudan University, Shanghai, China
- Department of Nursing, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
| | - Yi Zhang
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yaqiong Chen
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Mei Xue
- Department of Nursing, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xia Wang
- Department of Nursing, Obstetrics & Gynecology Hospital of Fudan University, Shanghai, China
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Rodrigues PFS, Bártolo A, Albuquerque PB. Memory Impairments and Wellbeing in Breast Cancer Patients: A Systematic Review. J Clin Med 2023; 12:6968. [PMID: 38002583 PMCID: PMC10672522 DOI: 10.3390/jcm12226968] [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: 09/04/2023] [Revised: 09/30/2023] [Accepted: 11/04/2023] [Indexed: 11/26/2023] Open
Abstract
Breast cancer is one of the most diagnosed cancers among women. Its effects on the cognitive and wellbeing domains have been widely reported in the literature, although with inconsistent results. The central goal of this review was to identify, in women with breast cancer, the main memory impairments, as measured by objective and subjective tools and their relationship with wellbeing outcomes. The systematic literature search was conducted in the PubMed, Scopus, and ProQuest databases. The selected studies included 9 longitudinal and 10 cross-sectional studies. Although some studies included participants undergoing multimodal cancer therapies, most focused on chemotherapy's effects (57.89%; n = 11). The pattern of results was mixed. However, studies suggested more consistently working memory deficits in breast cancer patients undergoing chemotherapy. In addition, some associations have been identified between objective memory outcomes (verbal memory) and wellbeing indicators, particularly depression and anxiety. The inconsistencies in the results could be justified by the heterogeneity of the research designs, objective and subjective measures, and sample characteristics. This review confirms that more empirical evidence is needed to understand memory impairments in women with breast cancer. An effort to increase the homogeneity of study methods should be made in future studies.
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Affiliation(s)
- Pedro F. S. Rodrigues
- I2P—Portucalense Institute for Psychology, Portucalense University, 4200-072 Porto, Portugal;
| | - Ana Bártolo
- I2P—Portucalense Institute for Psychology, Portucalense University, 4200-072 Porto, Portugal;
| | - Pedro B. Albuquerque
- CIPsi—Psychology Research Centre, School of Psychology, University of Minho, 4710-057 Braga, Portugal;
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Utne I, Stokke K, Ritchie C, Løyland B, Grov EK, Rasmussen HL, Lindemann K, Paul SM, Torstveit AH, Miaskowski C. Changes in Subjective Measures of Cognitive Function in Older Adults From the Initiation Through 12 Months After the Receipt of Chemotherapy. Cancer Nurs 2023; 46:E365-E374. [PMID: 35781267 DOI: 10.1097/ncc.0000000000001140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cognitive impairment has a negative impact on older patients with cancer. OBJECTIVES The aim of this study was to evaluate for interindividual differences in 2 subjective measures of cognitive function in older patients (n = 112), as well as determine which demographic, clinical, and symptom characteristics, and levels of physical function, were associated with initial levels and with the trajectory of each of these 2 measures. METHODS Cognitive function was assessed using the cognitive function scale from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and the Attentional Function Index at the initiation of chemotherapy and at 1, 3, 6, 9, and 12 months after its initiation. Hierarchical linear modeling was used to assess for interindividual differences in and characteristics associated with initial levels and changes in cognitive function. RESULTS Characteristics associated with decreases in Quality of Life Questionnaire Core 30 scores at the initiation of chemotherapy were longer time since the cancer diagnosis and higher depression scores. Characteristics associated with poorer Attentional Function Index scores at enrollment were lower levels of education and higher depression scores. No characteristics were associated with worse trajectories of either cognitive function measure. CONCLUSION Some older patients undergoing chemotherapy experience decrements in cognitive function. IMPLICATIONS FOR PRACTICE Our findings suggest that clinicians need to assess for depressive symptoms in older patients before the initiation of chemotherapy. Evidence-based interventions (eg, cognitive stimulation, increased physical activity) can be recommended to maintain and increase cognitive function in older oncology patients.
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Affiliation(s)
- Inger Utne
- Author Affiliations: Department of Nursing and Health Promotion, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University (Drs Utne, Løyland, and Grov, and Mss Rasmussen and Torstveit), Norway; Division of Cancer Medicine, Oslo University Hospital (Ms Stokke), Norway; Division of Palliative Care and Geriatric Medicine, Mongan Institute, Center for Aging and Serious Illness, Massachusetts General Hospital (Dr Ritchie), Boston; Department of Gynecological Oncology, Oslo University Hospital (Dr Lindemann), Norway; and School of Nursing, University of California, San Francisco (Drs Paul and Miaskowski)
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Allemann-Su YY, Vetter M, Koechlin H, Paul SM, Cooper BA, Oppegaard K, Melisko M, Levine JD, Conley Y, Miaskowski C, Katapodi MC. Pre-Surgery Demographic, Clinical, and Symptom Characteristics Associated with Different Self-Reported Cognitive Processes in Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14133281. [PMID: 35805053 PMCID: PMC9265628 DOI: 10.3390/cancers14133281] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/28/2022] [Accepted: 07/04/2022] [Indexed: 02/01/2023] Open
Abstract
Cancer related cognitive impairment (CRCI) is a common and persistent symptom in breast cancer patients. The Attentional Function Index (AFI) is a self-report measure that assesses CRCI. AFI includes three subscales, namely effective action, attentional lapses, and interpersonal effectiveness, that are based on working memory, inhibitory control, and cognitive flexibility. Previously, we identified three classes of patients with distinct CRCI profiles using the AFI total scores. The purpose of this study was to expand our previous work using latent class growth analysis (LCGA), to identify distinct cognitive profiles for each of the AFI subscales in the same sample (i.e., 397 women who were assessed seven times from prior to through to 6 months following breast cancer surgery). For each subscale, parametric and non-parametric statistics were used to determine differences in demographic, clinical, and pre-surgical psychological and physical symptoms among the subgroups. Three-, four-, and two-classes were identified for the effective action, attentional lapses, and interpersonal effectiveness subscales, respectively. Across all three subscales, lower functional status, higher levels of anxiety, depression, fatigue, and sleep disturbance, and worse decrements in energy were associated with worse cognitive performance. These and other modifiable characteristics may be potential targets for personalized interventions for CRCI.
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Affiliation(s)
- Yu-Yin Allemann-Su
- Department of Clinical Research, University of Basel, 4055 Basel, Switzerland;
| | - Marcus Vetter
- Department of Oncology, Cantonal Hospital Basel-Land, 4410 Listel, Switzerland;
| | - Helen Koechlin
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, 8050 Zurich, Switzerland;
- Division of Clinical Psychology and Psychotherapy, Faculty of Psychology, University of Basel, 4055 Basel, Switzerland
- Department of Anaesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Steven M. Paul
- School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA; (S.M.P.); (B.A.C.); (K.O.); (C.M.)
| | - Bruce A. Cooper
- School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA; (S.M.P.); (B.A.C.); (K.O.); (C.M.)
| | - Kate Oppegaard
- School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA; (S.M.P.); (B.A.C.); (K.O.); (C.M.)
| | - Michelle Melisko
- School of Medicine, University of California San Francisco, San Francisco, CA 94143, USA; (M.M.); (J.D.L.)
| | - Jon D. Levine
- School of Medicine, University of California San Francisco, San Francisco, CA 94143, USA; (M.M.); (J.D.L.)
| | - Yvette Conley
- School of Nursing, University of Pittsburgh, Pittsburgh, PA 15261, USA;
| | - Christine Miaskowski
- School of Nursing, University of California San Francisco, San Francisco, CA 94143, USA; (S.M.P.); (B.A.C.); (K.O.); (C.M.)
- School of Medicine, University of California San Francisco, San Francisco, CA 94143, USA; (M.M.); (J.D.L.)
| | - Maria C. Katapodi
- Department of Clinical Research, University of Basel, 4055 Basel, Switzerland;
- Correspondence: ; Tel.: +41-61-207-0430
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Mazanec SR, Park S, Connolly MC, Rosenzweig MQ. Factors associated with symptom distress in women with breast cancer prior to initiation of chemotherapy. Appl Nurs Res 2021; 62:151515. [PMID: 34815009 DOI: 10.1016/j.apnr.2021.151515] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/13/2021] [Accepted: 10/17/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Symptom distress in women with breast cancer is associated with early discontinuation of chemotherapy and may influence treatment outcomes. Describing racial differences in prechemotherapy symptom distress and examining contextual variables of the symptom experience may inform our understanding of the complex problem of racial disparities in breast cancer. AIM To determine if perceived social support, healthcare system distrust, and economic hardship predict symptom distress in women with breast cancer prior to their first chemotherapy treatment. DESIGN Descriptive, correlational, cross-sectional. METHODS Baseline data (N = 119) was used from a multisite, longitudinal study comparing the symptom experience and ability to receive chemotherapy of Black and White women with breast cancer (R01MD012245; Rosenzweig, PI). Measures included the Symptom Distress Scale, Interpersonal Support Evaluation List, Health Care System Distrust Scale, and Psychological Sense of Economic Hardship scale. The analysis consisted of multiple regression and a t-test. RESULTS On average, participants reported five symptoms prior to chemotherapy. Black women reported higher symptoms distress than White women; t(68.34) = 2.15, p = 0.035. The model explained 26% of variance in symptom distress; F(5, 112) = 9.01, p < 0.001. While controlling for age and race, greater perceived economic hardship contributed to higher symptom distress (β = 0.36, p = 0.001, 95% CI: 0.34 to 1.34). Race, health care system distrust and social support did not significantly predict symptom distress. CONCLUSION Assessment of perceived financial hardship prior to beginning chemotherapy is critical to identify those patients at risk for greater symptom distress.
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Affiliation(s)
- Susan R Mazanec
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-4904, United States of America; University Hospitals Seidman Cancer Center, 11100 Euclid Ave., Cleveland, OH 44106, United States of America.
| | - Sumin Park
- Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Ave., Cleveland, OH 44106-4904, United States of America.
| | - Mary C Connolly
- School of Nursing, University of Pittsburgh, 3500 Victoria St., Victoria Building, Pittsburgh, PA 15261, United States of America.
| | - Margaret Quinn Rosenzweig
- School of Nursing, University of Pittsburgh, 3500 Victoria St., Victoria Building, Pittsburgh, PA 15261, United States of America; UPMC Hillman Cancer Center, 5115 Centre Ave, Pittsburgh, PA 15232, United States of America.
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