Cognitive function of older patients receiving adjuvant chemotherapy for breast cancer: a pilot prospective longitudinal study.
OBJECTIVE
To report on the longitudinal cognitive functioning of older women receiving adjuvant chemotherapy for breast cancer.


METHODS
Neuropsychological and functional status testing were performed before chemotherapy and 6 months after chemotherapy.


METHODS
Cancer center.


METHODS
Thirty-one patients aged 65 and older with Stage I to III breast cancer. Of the 31 patients enrolled, three refused post-testing, and 28 were evaluable.


METHODS
The following domains of cognitive function were examined: attention; verbal memory; visual memory; and verbal, spatial, psychomotor, and executive functions.


RESULTS
Participants had a mean age of 71 (range 65-84): 39% Stage I, 50% Stage II, and 11% Stage III. The number of scores 2 standard deviations (SDs) below the norm were calculated for each patient before and 6 months after chemotherapy; 14 (50%) had no change, 11 (39%) worsened, and three (11%) improved (P=.05). Seven patients (25%) experienced a decline in cognitive function, defined as a 1-SD decline from pre- to post-testing in two or more neuropsychological domains. Exploratory analyses revealed no significant difference between functional status, comorbidity, and depression scale scores and change in overall quality-of-life scores before and after chemotherapy.


CONCLUSIONS
In this cohort of older women receiving adjuvant chemotherapy, a subset experienced a decline in cognitive function from before chemotherapy to 6 months after chemotherapy. Further prospective study is needed to confirm these observations and to identify the subgroup at special risk.
Hurria
Arti
A
Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. hurriaa@mskcc.org
Rosen
Carol
C
Hudis
Clifford
C
Zuckerman
Enid
E
Panageas
Katherine S
KS
Lachs
Mark S
MS
Witmer
Matthew
M
van Gorp
Wilfred G
WG
Fornier
Monica
M
D'Andrea
Gabriella
G
Moasser
Mark
M
Dang
Chau
C
Van Poznak
Catherine
C
Hurria
Anju
A
Holland
Jimmie
J
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000523:psychology*; D017024:Chemotherapy, Adjuvant; D003071:Cognition / Q000187:drug effects / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D009367:Neoplasm Staging; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011446:Prospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents