The effects of physical activity and fatigue on cognitive performance in breast cancer survivors

Ehlers, Diane K.; Aguiñaga, Susan; Cosman, Josh; Severson, Joan; Kramer, Arthur F.; McAuley, Edward

doi:10.1007/s10549-017-4363-9

Cited by 48 publications

(55 citation statements)

References 43 publications

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“…Finally, the potential interrelatedness of these domains highlights an opportunity for interventions to preserve both physical and cognitive function. There is some evidence that physical activity is helpful in treating CRCI; however, research evaluating the impact of physical activity on objectively measured cognitive function and in patients during the acute phase of cancer treatment is needed.…”

Section: Discussionmentioning

confidence: 99%

Associations of functional, psychosocial, medical, and socio‐demographic factors with cognitive screening in chemotherapy naïve patients with breast cancer

et al. 2018

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Objective To describe associations of functional, psychosocial, medical, and socio‐demographic factors with performance on a cognitive screening test in chemotherapy naïve patients with breast cancer. Methods Women with breast cancer were recruited between 2009 and 2018. The Blessed Orientation Memory Concentration Test (BOMC) was administered prior to chemotherapy. Associations between baseline BOMC and functional (Karnofsky Self‐Reported Performance Rating Scale (KPS), Time Up and Go Test (TUG), Medical Outcomes Study (MOS) Physical Function, Instrumental Activities of Daily Living (IADL)), psychosocial (Mental Health Inventory‐13, MOS Social Activity Limitation and Social Support Survey), medical, and socio‐demographic variables were assessed using linear regression analysis. Results In a sample of 331 women with breast cancer, the mean age was 65.2 years and 68.6% were 65 and older. Mean BOMC score was 3.60 on a scale from 0 (best) to 28 (worst). After controlling for demographic factors, worse BOMC screening test results were associated with KPS < 80 (P = 0.01), IADL<14 (P = 0.02), TUG ≥14 seconds (P = 0.001), worse MOS Physical Function (P = 0.0006), depressive symptoms (P = 0.04), and social activity limitations (P = 0.01). Conclusion In a sample of women with breast cancer, pre‐treatment cognitive screening scores did not reveal profound cognitive impairment. BOMC screening scores were associated with multiple measures of physical function, but further research is needed to determine a clinically meaningful cut point in the BOMC for screening of cancer‐related cognitive impairment.

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Section: Discussionmentioning

confidence: 99%

Associations of functional, psychosocial, medical, and socio‐demographic factors with cognitive screening in chemotherapy naïve patients with breast cancer

et al. 2018

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“…We conducted a pooled analysis of 753 breast cancer survivors from two observational studies (study 1: n = 440 and study 2: n = 313) for a total sample size of 753 in the present analysis. Full details on study 1 and study 2 can be found in previously published manuscripts of the studies main aims. For the current analysis, participants from both studies were included if they had accelerometer data with at least four valid days, defined as at least 10 hours of accelerometer wear time for each day, and complete data on demographic and QOL outcome assessment .…”

Section: Methodsmentioning

confidence: 99%

Effects of reallocating sedentary time with physical activity on quality of life indicators in breast cancer survivors

et al. 2019

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Objectives Physical activity is associated with better quality of life (QOL) among breast cancer survivors. However, it is unknown the extent to which time spent sedentary or replacing this time with active behaviors may affect QOL. Our aim was to determine the effect of substituting time between sedentary and active behaviors on QOL indicators in breast cancer survivors. Methods An isotemporal substitution approach was used to examine the associations of reallocating time to sedentary and active behaviors measured by accelerometry with Functional Assessment of Cancer Treatment—Breast (FACT‐B; total, physical, social, emotional, functional well‐being, and breast cancer–specific concerns) and the Hospital Anxiety and Depression Scale (HADS) scores in a pooled analysis of breast cancer survivors (n = 753; Mage = 56.9 ± 9.5 y) from two observational studies. Results Reallocating 30 minutes of sedentary time to 30 minutes of moderate‐to‐vigorous intensity physical activity (MVPA) was associated with improved FACT‐B total (B = 3.0; 95% CI, 0.6‐4.5), physical well‐being (B = 0.8; 95% CI, 0.33‐1.2), and functional well‐being (B = 0.6; 95% CI, 0.03‐1.2) scores. Reallocating 30 minutes of light activity to 30 minutes of MVPA was associated with improved FACT‐B total (B = 2.4; 95% CI, 0.3‐6.0) and physical well‐being (B = 0.72; 95% CI, 0.27‐1.2) scores. There was no significant substitution of time effects on HADS scores. Conclusions Substituting sedentary time with MVPA showed the greatest range of effects across QOL indicators. These results can inform intervention development interventions and more comprehensive activity recommendations for breast cancer survivors.

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“…Much of the previous research on CACD has examined factors that differ between persons such as treatment modality, cognitive reserve, symptomatology (eg, fatigue and depression), and genetic polymorphisms . These between‐person differences in risk factors, however, are only inconsistently associated with performance on traditional neuropsychological testing.…”

Section: Introductionmentioning

confidence: 99%

Cognitive performance of breast cancer survivors in daily life: Role of fatigue and depressed mood

et al. 2019

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Objective Cancer and its treatment are associated with long‐term cognitive deficits. However, most studies of cancer patients have used traditional, office‐based cognitive evaluations instead of assessing patients in their daily lives. Recent research in cognitive aging suggests that variability in performance may be a sensitive indicator of cognitive decline. Using ecological momentary assessment (EMA), we examined cognitive variability among breast cancer survivors and evaluated whether ratings of fatigue and depressed mood were associated with cognition. Methods Participants were 47 women (M age = 53.3 years) who completed treatment for early stage breast cancer 6 to 36 months previously. Smartphones were preloaded with cognitive tests measuring processing speed, executive functioning, and memory, as well as rating scales for fatigue and depressed mood. Participants were prompted five times per day over a 14‐day period to complete EMA cognitive tasks and fatigue and depressed mood ratings. Results Cognitive variability was observed across all three EMA cognitive tasks. Processing speed responses were slower at times that women rated themselves as more fatigued than their average (P < .001). Ratings of depressed mood were not associated with cognition. Conclusions This study is the first to report cognitive variability in the daily lives of women treated for breast cancer. Performance was worse on a measure of processing speed at times when a woman rated her fatigue as greater than her own average. The ability to identify moments when cognition is most vulnerable may allow for personalized interventions to be applied at times when they are most needed.

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The effects of physical activity and fatigue on cognitive performance in breast cancer survivors

Cited by 48 publications

References 43 publications

Associations of functional, psychosocial, medical, and socio‐demographic factors with cognitive screening in chemotherapy naïve patients with breast cancer

Associations of functional, psychosocial, medical, and socio‐demographic factors with cognitive screening in chemotherapy naïve patients with breast cancer

Effects of reallocating sedentary time with physical activity on quality of life indicators in breast cancer survivors

Cognitive performance of breast cancer survivors in daily life: Role of fatigue and depressed mood

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