title: Predictors of cognitive decline after chemotherapy in breast cancer patients.
abstract: The objective of this study is to identify whether decline in cognitive functioning after chemotherapy in women with breast cancer is associated with health/disease, treatment, and psychological variables. Neuropsychological performance, health/disease, and treatment-related information of 136 women with breast cancer (age M = 49.38; SD = 7.92; range = 25.25-67.92) was assessed pre-chemotherapy and 1-month post-chemotherapy. The Reliable Change Index corrected for practice (RCIp) identified women whose performance significantly declined, while Pearson correlations assessed the relationship between cognitive change and predictor variables. A total of 16.9% of women showed significant decline post-chemotherapy, with affected domains including verbal learning and memory, abstract reasoning, and motor coordination. Decline in hemoglobin levels and increased anxiety over the course of chemotherapy was found to significantly predict impairment in multiple cognitive measures. Change in specific cognitive measures was significantly associated with baseline fatigue, depression, and functional well-being (r = 0.23 to 0.33; p = .01 to < .001). Although the effects are small, there is evidence that psychological and health factors may increase vulnerability to cognitive dysfunction after chemotherapy for breast cancer. Significant associations reported in this study may be useful in the identification and treatment of at-risk individuals.
authors.affiliation: The University of Queensland, School of Psychology, Brisbane, Australia. k.vearncombe@psy.uq.edu.au
authors.forename: Katharine J
authors.initials: KJ
authors.lastname: Vearncombe
authors.forename: Margaret
authors.initials: M
authors.lastname: Rolfe
authors.forename: Margaret
authors.initials: M
authors.lastname: Wright
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Pachana
authors.forename: Brooke
authors.initials: B
authors.lastname: Andrew
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Beadle
mesh_terms: D000328:Adult; D000368:Aged; D001288:Attention; D001943:Breast Neoplasms / Q000188:drug therapy; D003072:Cognition Disorders / Q000209:etiology*; D064420:Drug-Related Side Effects and Adverse Reactions; D056344:Executive Function / Q000502:physiology; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D006801:Humans; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009367:Neoplasm Staging; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011597:Psychomotor Performance / Q000502:physiology; D011960:Receptors, Estrogen / Q000378:metabolism; D015203:Reproducibility of Results; D012649:Self Concept; D013997:Time Factors; D014706:Verbal Learning / Q000187:drug effects; D014796:Visual Perception / Q000187:drug effects
chemical_list: D011960:Receptors, Estrogen