Cognition, quality‐of‐life, and symptom clusters in breast cancer: Using Bayesian networks to elucidate complex relationships

Xu, Selene; Thompson, Wesley K.; Ancoli‐Israel, Sonia; Liu, Lianqi; Palmer, Barton W.

doi:10.1002/pon.4571

Cited by 49 publications

(41 citation statements)

References 34 publications

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“…The pattern of correlations found between PSQI and the cognitive variables suggests that self‐reported sleep quality indices are related to PCI but not to cognitive performance of verbal fluency, attention, executive functioning, or memory, which is congruent with some previous research but contrary to findings from Xu et al who reported that sleep quality was a significant predictor of neuropsychological performance in BCS receiving chemotherapy. The women in our sample performed average to above average on the neuropsychological tests, possibly because they were highly educated and therefore had high cognitive reserve.…”

Section: Discussionsupporting

confidence: 79%

Relationships between self‐reported sleep quality components and cognitive functioning in breast cancer survivors up to 10 years following chemotherapy

et al. 2018

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Findings support links between sleep quality and perceived cognitive impairments in BCS and suggest specific components of sleep quality (daytime dysfunction, sleep efficiency, and sleep disturbance) are associated with perceived cognitive functioning in this population. Findings can assist clinicians in guiding survivors to manage sleep and cognitive problems and aid in the design of interventional research.

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Section: Discussionsupporting

confidence: 79%

Relationships between self‐reported sleep quality components and cognitive functioning in breast cancer survivors up to 10 years following chemotherapy

et al. 2018

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“…In a cross‐sectional analysis of 1072 breast cancer survivors, approximately 71.7% of patients with severe insomnia reported moderate or greater cognitive difficulties compared with only 20.0% of patients without insomnia 28 . Thus, improving sleep has been identified as a potential management strategy for patients with CRCI 29‐31 …”

Section: Introductionmentioning

confidence: 99%

Effects of acupuncture versus cognitive behavioral therapy on cognitive function in cancer survivors with insomnia: A secondary analysis of a randomized clinical trial

Liou

Root

Garland

et al. 2020

Cancer

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Background Cancer‐related cognitive impairment is a prevalent, disruptive condition potentially exacerbated by sleep disturbances. The current study was performed to evaluate the effects of acupuncture versus cognitive behavioral therapy for insomnia (CBT‐I) on objective and subjective cognitive function in cancer survivors with insomnia. Methods Using data from a randomized clinical trial (160 survivors) that compared acupuncture versus CBT‐I for insomnia occurring in cancer survivors, the authors analyzed cognitive outcomes and their relationship to insomnia symptoms. Analysis was limited to 99 patients who reported baseline cognitive difficulties. Interventions were delivered over 8 weeks. Objective attention, learning, and memory were evaluated using the Buschke Selective Reminding Test. Subjective cognitive function was assessed using the Brown Attention‐Deficit Disorder Scales. Insomnia symptoms were assessed using the Insomnia Severity Index. All outcomes were collected at baseline, week 8, and week 20. Results From baseline to week 8, acupuncture produced statistically significant within‐group improvements in objective attention (Cohen D, 0.29), learning (Cohen D, 0.31), and memory (Cohen D, 0.33) that persisted to week 20 (all P < .05), whereas CBT‐I produced a statistically significant within‐group improvement in objective attention from baseline to week 20 (Cohen D, 0.50; P < .05); between‐group differences were not statistically significant. Both interventions produced statistically significant within‐group improvements in subjective cognitive function at weeks 8 and 20 compared with baseline (all P < .001); between‐group differences were not statistically significant. In the acupuncture group, patients with clinically meaningful responses with regard to insomnia symptoms demonstrated a significantly greater improvement in subjective cognitive function compared with those without clinically meaningful insomnia responses (P = .006). Conclusions Among cancer survivors with insomnia, both acupuncture and CBT‐I produced significant improvements in objective and subjective cognitive function. However, the effect sizes varied and only survivors in the acupuncture group demonstrated a significant relationship between cognitive and sleep outcomes. These preliminary findings warrant further investigation to guide the personalized management of patients with cancer‐related cognitive impairment.

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“…Adjuvant curative therapies are applied in the majority of cases that possibly influence their cognitive functioning and psychological well-being (2)(3)(4)(5). The adverse effects of adjuvant therapies on cognitive functioning including verbal memory (immediate and delayed recall), visuo-spatial memory, executive functioning, attention/concentration, psychomotor speed, verbal fluency, verbal articulation (language skills) may exert profound effects on quality of life (QOL) (6)(7)(8). Chemotherapy-related cognitive deterioration originally named as "chemobrain" is a wellknown phenomenon which includes various chemotherapyinduced deficits and impairments such as decline of verbal memory and psychomotor functioning (3,(9)(10)(11).…”

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confidence: 99%

Cognitive Functioning and Psychological Well-being in Breast Cancer Patients on Endocrine Therapy

Biró

Kahán

Kálmán

et al. 2019

In Vivo

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Background/Aim: Anti-cancer therapies may deteriorate cognitive functioning, affective functioning and psychological well-being. Materials and Methods: In this prospective longitudinal pilot study, premenopausal and postmenopausal patients received adjuvant endocrine therapy (ET) (tamoxifen with or without LHRH analog or aromatase inhibitor) or were observed only (control group). At baseline testing and 6, 12 and 24 months thereafter, cognitive, depression and anxiety tests and quality of life (QOL) measurements were performed. Results: Overall, 46 cases were evaluated. None of the studied cognitive parameters differed between the subgroups or changed by time. No differences were found regarding anxiety, depression or QOL measures either. Baseline cognitive test and QOL results were in association with later anxiety and depression. Conclusion: No cognitive impairment was found during the two years of ET. Baseline cognitive scores and QOL dimensions proved good predictors of later anxiety and depression.

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Cognition, quality‐of‐life, and symptom clusters in breast cancer: Using Bayesian networks to elucidate complex relationships

Abstract: The Bayesian network identified local structure (eg, fatigue-mood-QoL or sleep-cognition) and possible intervention targets (eg, a sleep intervention to reduce cognitive complaints during chemotherapy).

Cited by 49 publications

References 34 publications

Relationships between self‐reported sleep quality components and cognitive functioning in breast cancer survivors up to 10 years following chemotherapy

Relationships between self‐reported sleep quality components and cognitive functioning in breast cancer survivors up to 10 years following chemotherapy

Effects of acupuncture versus cognitive behavioral therapy on cognitive function in cancer survivors with insomnia: A secondary analysis of a randomized clinical trial

Cognitive Functioning and Psychological Well-being in Breast Cancer Patients on Endocrine Therapy

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