title: Neurocognitive functioning and health-related behaviours in adult survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
abstract: BACKGROUND
  Positive health-related behaviours are essential for the future wellbeing of childhood cancer survivors, though relatively few maintain healthy behaviours into adulthood.
  
  
  METHODS
  Neurocognitive function and emotional distress were examined in 6,440 adult survivors from the Childhood Cancer Survivor Study, and used to predict rates of expected health-related behaviours. Covariates included cancer diagnosis, age, sex, body mass index, insurance status, income and antidepressant medication use, and multivariable models were constructed adjusting for these factors.
  
  
  RESULTS
  In multivariable regression models, survivors with neurocognitive problems in task efficiency (RR=0.77, 95% CI=0.72-0.84) were less likely to meet the Centers for Disease Control guidelines for weekly physical activity. Survivors with neurocognitive impairment were more likely to engage in general survivor care (RR=1.20, 95% CI=1.10-1.30), and less likely to engage in dental care (RR=0.92, 95% CI=0.88-0.97). Obese survivors were less likely to report receiving a bone density exam (RR=0.67, 95% CI=0.54-0.82), a mammogram (RR=0.71, 95% CI=0.57-0.89), and a skin exam (RR=0.78, 95% CI=0.68-0.89). Survivors reporting somatisation, i.e. vague physical symptoms associated with anxiety, were more likely to report receiving echocardiograms (RR=1.53, 95% CI=1.32-1.77).
  
  
  CONCLUSIONS
  These results support the link between neurocognitive and emotional problems and health-related behaviours in adult survivors of childhood cancer. Monitoring neurocognitive and emotional outcomes may help to identify survivors at risk for poor adherence to prescribed health behaviours and health screening exams.
authors: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN 38105-3678, United States. kevin.krull@stjude.org
authors: Kevin R
authors: KR
authors: Krull
authors: Robert D
authors: RD
authors: Annett
authors: Zhenyu
authors: Z
authors: Pan
authors: Kirsten K
authors: KK
authors: Ness
authors: Paul C
authors: PC
authors: Nathan
authors: Deo Kumar
authors: DK
authors: Srivastava
authors: Marilyn
authors: M
authors: Stovall
authors: Leslie L
authors: LL
authors: Robison
authors: Melissa M
authors: MM
authors: Hudson
mesh_terms: D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000150:complications; D000928:Antidepressive Agents / Q000627:therapeutic use; D015992:Body Mass Index; D002648:Child; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000523:psychology* / Q000628:therapy*; D009765:Obesity / Q000150:complications; D010349:Patient Compliance; D012648:Self Care; D017741:Survivors; D013997:Time Factors
chemical_list: D000928:Antidepressive Agents