title: Relationships among attention function, exercise, and body mass index: a comparison between young breast cancer survivors and acquaintance controls.
abstract: OBJECTIVE
  Although regular physical activity is associated with lower all-cause and disease-specific mortality among breast cancer survivors (BCS), most BCS do not meet its recommended guidelines. Attention function, a domain of cognition, is essential for daily tasks such as exercising, a form of planned physical activity. We tested the hypotheses that lower self-reported attention function in BCS would be associated with less exercise and higher body mass index (BMI) by comparing a group of 505 young BCS (45 years or younger at diagnosis and 3-8 years post-treatment) with 466 acquaintance controls (AC).
  
  
  METHODS
  The groups were compared on self-reported physical and psychological outcomes. Mplus software was used to perform confirmatory structural equation modeling with a robust maximum likelihood estimator to evaluate hypothesized relationships among variables. The criteria for good model fit were having root mean square error of approximation (RMSEA) < 0.06, comparative fit index (CFI) > 0.95, and standardized root mean square residual (SRMR) < 0.08. Modification indices were used to better fit the model.
  
  
  RESULTS
  The final model demonstrated good fit, with RMSEA = 0.05, CFI = 0.98, and SRMR = 0.03. After controlling for demographics, parameter estimates revealed that, compared with AC, young BCS reported worse attention function (p < 0.001), more depressive symptoms (p < 0.001), and more fatigue (p < 0.001). Controlling for fatigue, depression, and anxiety, better attention function was associated with a greater likelihood of exercise in the past 3 months (p = 0.039), which in turn was associated with a lower BMI (p < 0.001).
  
  
  CONCLUSIONS
  The significant association between attention function and physical activity, if confirmed in a longitudinal study, will provide new targets for interventions aimed at improving physical activity and decreasing BMI among BCS.
authors.affiliation: Department of Pediatric Hematology-Oncology, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Kamnesh R
authors.initials: KR
authors.lastname: Pradhan
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Stump
authors.forename: Patrick
authors.initials: P
authors.lastname: Monahan
authors.forename: Victoria
authors.initials: V
authors.lastname: Champion
mesh_terms: D000328:Adult; D000367:Age Factors; D001007:Anxiety; D001288:Attention / Q000502:physiology*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000523:psychology*; D016022:Case-Control Studies; D003863:Depression; D015444:Exercise / Q000502:physiology / Q000523:psychology*; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009042:Motivation; D009043:Motor Activity; D011788:Quality of Life; D057566:Self Report; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology
keywords: attention function; body mass index; cancer; exercise; oncology