Cognitive Changes Associated with Cancer and Cancer Therapy: Patient Assessment and Education

Jansen, Catherine E.

doi:10.1016/j.soncn.2013.08.007

Cited by 16 publications

(14 citation statements)

References 35 publications

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“… 39 There are also additional concerns that these assessments may not be sensitive to detect subtle cognitive impairment incurred by patients. 40 While studies have suggested that self-perceived cognitive impairment may indicate the presence of other emotional distress elements more than cognitive impairment, it is still unclear whether the emotional distress is attributed to the existing cognitive issues or vice versa. Furthermore, subjective cognitive impairment has shown to be associated with brain structural changes among individuals who had normal neuropsychological test performance.…”

Section: Discussionmentioning

confidence: 99%

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Brain-derived neurotrophic factor genetic polymorphism (rs6265) is protective against chemotherapy-associated cognitive impairment in patients with early-stage breast cancer

Teo

Yeo

et al. 2015

Neuro Oncol

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BackgroundBrain-derived neurotrophic factor (BDNF), a neurotrophin that regulates neuronal function and development, is implicated in several neurodegenerative conditions. Preliminary data suggest that a reduction of BDNF concentrations may lead to postchemotherapy cognitive impairment. We hypothesized that a single nucleotide polymorphism (rs6265) of the BDNF gene may predispose patients to cognitive impairment. This study aimed to evaluate the effect of BDNF gene polymorphism on chemotherapy-associated cognitive impairment.MethodsOverall, 145 patients receiving chemotherapy for early-stage breast cancer (mean age: 50.8 ± 8.8 y; 82.1% Chinese) were recruited. Patients' cognitive functions were assessed longitudinally using the validated Functional Assessment of Cancer Therapy–Cognitive Function (v.3) and an objective computerized tool, Headminder. Genotyping was performed using Sanger sequencing. Logistic regression was used to evaluate the association between BDNF Val66Met polymorphism and cognition after adjusting for ethnicity and clinically important covariates.ResultsOf the 145 patients, 54 (37%) reported cognitive impairment postchemotherapy. The Met/Met genotype was associated with statistically significant lower odds of developing cognitive impairment (odds ratio [OR] = 0.26; 95% CI: 0.08–0.92; P = .036). The Met carriers were less likely to experience impairment in the domains of verbal fluency (OR = 0.34; 95% CI: 0.12–0.90; P = .031) and multitasking ability (OR = 0.37; 95% CI: 0.15–0.91; P = .030) compared with the Val/Val homozygote. No associations were observed between Headminder and the BDNF Val66Met polymorphism.ConclusionsThis is the first study to provide evidence that carriers of the BDNF Met allele are protected against chemotherapy-associated cognitive impairment. Further studies are required to validate the findings.

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Section: Discussionmentioning

confidence: 99%

“… 41 , 42 Hence, we highly value the measures provided by subjective reporting using patient-reported outcomes because the tool provides insights into how cognitive deficits impact patients' QoL and daily functioning, which are useful in detecting subtle cognitive changes. 39 , 40 , 43 …”

Section: Discussionmentioning

confidence: 99%

Brain-derived neurotrophic factor genetic polymorphism (rs6265) is protective against chemotherapy-associated cognitive impairment in patients with early-stage breast cancer

Teo

Yeo

et al. 2015

Neuro Oncol

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“…Although self-report of cognitive problems is generally not related to objectively measured cognitive function (Bender et al, 2008), cognitive problems are commonly related to self-reports of fatigue and, therefore, may be an indirect indication of poorer cognitive function (Downie, Mar Fan, Houédé-Tchen, & Tannock, 2006; Merriman et al, 2017). Assessing women for other factors that may increase their risk for poorer cognitive function is important; these include previous cancer and cancer therapy, certain comorbidities, such as a history of substance abuse, and neurologic disease or neurotrauma and serious psychiatric illness, such as clinical depression and concomitant medications (Jansen, 2013). Nurses should also assess the functional and emotional implications of changes in cognitive function.…”

Section: Implications For Practice and Future Researchmentioning

confidence: 99%

Trajectories of Cognitive Function and Associated Phenotypic and Genotypic Factors in Breast Cancer

Bender¹,

Merriman²,

Sereika³

et al. 2018

ONF

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OBJECTIVES This study identified women with unique trajectories of executive function, concentration, and visual working memory before and during adjuvant therapy for breast cancer, and examined phenotypic and genotypic predictors associated with subgroups. SAMPLE & SETTING 399 postmenopausal women, of whom 288 were women with early-stage breast cancer and 111 were women without breast cancer, matched on age and years of education to the women with breast cancer, and all at an urban cancer center. METHODS & VARIABLES A repeated-measures design was used; assessments occurred before adjuvant therapy and every six months post-therapy initiation. Group-based trajectory modeling determined subgroups. Multinomial logistic regression identified phenotypic and genotypic characteristics. RESULTS Three executive function and concentration trajectory subgroups were identified: low, moderate, and high; two visual working memory subgroups were identified: low and high. IMPLICATIONS FOR NURSING Advancing age, greater pretherapy fatigue, and poorer pretherapy cognitive function are associated with the low subgroups. DNA repair and oxidative stress mechanisms may be involved in the cognitive changes that women experience.

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“…Survivors often will express concerns regarding memory lapses (remembering names, dates, and places), inability to concentrate, and difficulty following instructions or completing tasks. These concerns should be fully assessed and referred to other healthcare professionals (e.g., neuropsychologist, psychiatrist) for evaluation if they disrupt everyday functioning (Jansen, 2013). At a minimum, nurses should acknowledge the survivors' cognitive concerns because research has suggested that the acknowledgement alone can reduce distress.…”

Section: Cognitive Trainingmentioning

confidence: 99%

Cognitive Changes Associated With Cancer and Cancer Treatment: State of the Science

2015

CJON

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Cognitive Changes Associated with Cancer and Cancer Therapy: Patient Assessment and Education

Cited by 16 publications

References 35 publications

Brain-derived neurotrophic factor genetic polymorphism (rs6265) is protective against chemotherapy-associated cognitive impairment in patients with early-stage breast cancer

Brain-derived neurotrophic factor genetic polymorphism (rs6265) is protective against chemotherapy-associated cognitive impairment in patients with early-stage breast cancer

Trajectories of Cognitive Function and Associated Phenotypic and Genotypic Factors in Breast Cancer

Cognitive Changes Associated With Cancer and Cancer Treatment: State of the Science

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