title: Self-Reported History of Chemotherapy and Cognitive Decline in Adults Aged 60 and Older: The PATH Through Life Project.
abstract: BACKGROUND
  There is a lack of data from cohort studies assessing cognitive function prior to and after chemotherapy. We evaluated the effect of self-reported cancer chemotherapy on cognitive function in a cohort assessed at baseline, 4 and 8 years.
  
  
  METHODS
  Participants were from the population-based PATH Through Life Study. Of the 2,551 participants aged 60-64 at baseline without cognitive impairment, 1,949 completed wave 3 and had data on cancer and chemotherapy and cognitive function. Linear mixed models were used to analyze the data.
  
  
  RESULTS
  At wave 3, participants reporting history of chemotherapy (n = 76) had lower scores on memory, processing speed, and executive function compared with those reporting cancer without chemotherapy (n = 289) and no cancer history (n = 1508). After adjustment for depression and disability, effects remained for processing speed and memory. Chemotherapy prior to the study commencement (n = 24), but not between waves 1 and 3 (n = 81), was associated with greater decline in delayed recall (β = -.21 [95% CI -0.38, -.03], p = .02) and digits backwards β = -.05 [95% CI -0.09, -.01], p = .02) over 8 years compared with those with no cancer history (n = 1562). Women reporting chemotherapy for breast cancer after wave 1 (n = 26) had slower choice reaction time (-0.81 (95% CI -1.28, -0.34), p = .001) but did not decline faster on this measure compared with those reporting no breast cancer history (n = 818).
  
  
  CONCLUSIONS
  Results suggest chemotherapy prior to old age is associated with faster decline in memory in late life but that it does not affect decline in other domains of cognitive function.
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia. Kaarin.Anstey@anu.edu.au.
authors.forename: Kaarin J
authors.initials: KJ
authors.lastname: Anstey
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia.
authors.forename: Kerry
authors.initials: K
authors.lastname: Sargent-Cox
authors.affiliation: Centre for Research on Ageing, Health and Wellbeing, The Australian National University, Canberra, Australia.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Cherbuin
authors.affiliation: Centre for Healthy Brain Ageing, The University of New South Wales, Sydney, Australia.
authors.forename: Perminder S
authors.initials: PS
authors.lastname: Sachdev
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001315:Australia / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology; D009483:Neuropsychological Tests; D011930:Reaction Time; D057566:Self Report
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer; Cognitive decline; Epidemiology; Longitudinal study.; Mild cognitive impairment