title: The association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients.
abstract: BACKGROUND
  The causes of cancer-related fatigue, which can influence patients' activities, are multidimensional; however, little is known about the cognitive dimension. We examined the association of cognitive fatigue with menopause, depressive symptoms, and quality of life in ambulatory breast cancer patients after primary treatment.
  
  
  METHODS
  This descriptive, cross-sectional study recruited 20-64-year-old breast cancer patients in an outpatient setting. The patients (N = 93; mean age = 53 years) were divided into low (L-CogF) and high-cognitive fatigue (H-CogF) groups according to their scores on the cognitive fatigue subscale of the Cancer Fatigue Scale. We compared the groups on their sociodemographic and medical characteristics and scores on the Functional Assessment of Cancer Therapy-Breast (FACT-B) [a measure of quality of life (QOL)], Simplified Menopausal Index (SMI), and Self-Rating Questionnaire for Depression (SRQ-D).
  
  
  RESULTS
  The L-CogF (n = 55) and H-CogF (n = 38) patients did not differ in age, years since diagnosis, marital status, educational background, or treatment history. Total and subscale FACT-B scores, except for physical well-being, were significantly lower in H-CogF participants than in L-CogF participants. SMI and SRQ-D scores were significantly higher in H-CogF participants. Employed H-CogF participants were concerned about keeping their jobs (p < 0.05).
  
  
  CONCLUSIONS
  Breast cancer patients with high-cognitive fatigue suffer from severe menopause and depressive symptoms, and deteriorating QOL. Cognitive fatigue should be considered when interpreting patients' cognitive complaints.
authors.affiliation: Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daikominami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan. kmiura@med.nagoya-u.ac.jp.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Miura
authors.affiliation: Department of Nursing, Nagoya University Graduate School of Medicine, 1-1-20 Daikominami, Higashi-ku, Nagoya, Aichi, 461-8673, Japan.
authors.forename: Shoko
authors.initials: S
authors.lastname: Ando
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Aichi Medical University, Nagakute, Aichi, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Imai
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000209:etiology*; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology*; D005260:Female; D006801:Humans; D007564:Japan; D008593:Menopause / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
keywords: Breast cancer; Cognitive fatigue; Depression; Menopause; Quality of life