title: Cognitive function of older patients receiving adjuvant chemotherapy for breast cancer: a pilot prospective longitudinal study.
abstract: 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.
authors.affiliation: Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA. hurriaa@mskcc.org
authors.forename: Arti
authors.initials: A
authors.lastname: Hurria
authors.forename: Carol
authors.initials: C
authors.lastname: Rosen
authors.forename: Clifford
authors.initials: C
authors.lastname: Hudis
authors.forename: Enid
authors.initials: E
authors.lastname: Zuckerman
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Panageas
authors.forename: Mark S
authors.initials: MS
authors.lastname: Lachs
authors.forename: Matthew
authors.initials: M
authors.lastname: Witmer
authors.forename: Wilfred G
authors.initials: WG
authors.lastname: van Gorp
authors.forename: Monica
authors.initials: M
authors.lastname: Fornier
authors.forename: Gabriella
authors.initials: G
authors.lastname: D'Andrea
authors.forename: Mark
authors.initials: M
authors.lastname: Moasser
authors.forename: Chau
authors.initials: C
authors.lastname: Dang
authors.forename: Catherine
authors.initials: C
authors.lastname: Van Poznak
authors.forename: Anju
authors.initials: A
authors.lastname: Hurria
authors.forename: Jimmie
authors.initials: J
authors.lastname: Holland
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents