title: Potential factors associated with perceived cognitive impairment in breast cancer survivors.
abstract: OBJECTIVE
  This cross-sectional study was designed to explore potential factors associated with perceived cognitive impairment (PCI) in breast cancer survivors compared to controls and gain insight into perceived levels of severity for cognitive complaints.
  
  
  METHODS
  Women (N = 363, 317: breast cancer, 46: healthy controls) completed demographic questionnaire, MD Anderson Symptom Inventory, Attentional Function Index, and Functional Assessment for Cancer Therapy-Cognition. Group classification included pre-chemotherapy, current chemotherapy, and postchemotherapy (<1, >1- < 2, >2- < 5, >5 years).
  
  
  RESULTS
  A significant group effect was seen for PCI (F 6, 355 = 7.01, p < 0.0001). Controls reported less PCI than all other groups. Neuropathy was inversely correlated with PCI (r = -0.23; p < 0.0001) for participants with breast cancer. A significant association was demonstrated between exercise frequency and PCI in women exposed to chemotherapy (F 3, 135 = 3.78, p < 0.05). A multiple linear regression model built using forward selection methods explained 24 % of the variance (adjusted R (2)) for PCI in breast cancer participants and included group, body mass index (BMI), exercise, fatigue, and distress. Exercise frequency moderated the relationship between BMI and PCI for breast cancer participants (F 3, 198 = 2.4, p = 0.07) and reduced the negative effects of high BMI. The moderating effect of exercise was significant (F 3, 133 = 3.1, p = 0.03) when limited to participants exposed to chemotherapy.
  
  
  CONCLUSIONS
  PCI decreased for women >5 years postchemotherapy. Overweight survivors who exercised frequently reported less PCI than sedentary survivors. Study results provide support for a relationship between BMI and PCI in breast cancer survivors and exercise as a potential intervention for cognitive complaints. Further investigation of the influence of weight and exercise on cognitive function is warranted.
authors.affiliation: School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA. jmyers@kumc.edu.|School of Nursing, University of Kansas, 10613 Riverview Ave, Edwardsville, KS, 66111, USA. jmyers@kumc.edu.
authors.forename: Jamie S
authors.initials: JS
authors.lastname: Myers
authors.affiliation: Biostatistics, University of Kansas Medical Center, 3901 Rainbow Blvd, Mail Stop 1026, Kanas City, KS, 66160, USA.
authors.forename: Jo A
authors.initials: JA
authors.lastname: Wick
authors.affiliation: Division of Oncology, University of Kansas Cancer Center, 2330 Shawnee Mission Parkway, Westwood, KS, 66205, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Klemp
mesh_terms: D000328:Adult; D000368:Aged; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology*; D003430:Cross-Sectional Studies; D015444:Exercise / Q000502:physiology*; D005221:Fatigue / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D010465:Perception; D011788:Quality of Life / Q000523:psychology*; D012649:Self Concept; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology
keywords: Breast cancer; Chemotherapy; Cognitive function; Exercise patterns; Neuropathy; Obesity
references.citation: Neurology. 2006 Sep 12;67(5):834-42
references.pmid: 16966547
references.citation: Clin Oncol (R Coll Radiol). 2002 Feb;14(1):64-7
references.pmid: 11898788
references.citation: Clin Pharmacol Ther. 2011 Sep;90(3):366-76
references.pmid: 21814191
references.citation: J Geriatr Oncol. 2012 Apr 1;3(2):90-97
references.pmid: 22712028
references.citation: J Clin Oncol. 2012 Apr 1;30(10):1080-6
references.pmid: 22370315
references.citation: Oncol Nurs Forum. 2010 Jul;37(4):423-32
references.pmid: 20591802
references.citation: Cancer. 2000 Oct 1;89(7):1634-46
references.pmid: 11013380
references.citation: J Biol. 2006;5(7):22
references.pmid: 17125495
references.citation: Psychooncology. 2011 Feb;20(2):194-202
references.pmid: 20213858
references.citation: Nat Rev Neurosci. 2012 Mar;13(3):209-16
references.pmid: 22251954
references.citation: Clin Interv Aging. 2014;9:51-62
references.pmid: 24379659
references.citation: JAMA. 2004 Sep 22;292(12):1454-61
references.pmid: 15383516
references.citation: Obesity (Silver Spring). 2013 Jul;21(7):1343-9
references.pmid: 23671055
references.citation: Arch Phys Med Rehabil. 2010 Sep;91(9 Suppl):S38-43
references.pmid: 20801278
references.citation: Psychol Sci. 2003 Mar;14(2):125-30
references.pmid: 12661673
references.citation: Appl Physiol Nutr Metab. 2014 Jun;39(6):724-9
references.pmid: 24869976
references.citation: Oncol Nurs Forum. 2010 Sep;37(5):596-603
references.pmid: 20797951
references.citation: J Pain Symptom Manage. 2014 Apr;47(4):721-30
references.pmid: 23880589
references.citation: JAMA. 2004 Nov 10;292(18):2237-42
references.pmid: 15536110
references.citation: Psychooncology. 2006 May;15(5):422-30
references.pmid: 16097037
references.citation: Oncol Nurs Forum. 2007 Sep;34(5):981-94
references.pmid: 17878127
references.citation: J Am Geriatr Soc. 2013 Nov;61(11):1919-26
references.pmid: 24219193
references.citation: Cancer Invest. 2001;19(8):812-20
references.pmid: 11768035
references.citation: J Neurosci. 2014 Feb 12;34(7):2618-31
references.pmid: 24523551
references.citation: Arch Neurol. 2001 Mar;58(3):498-504
references.pmid: 11255456
references.citation: Contemp Clin Trials. 2012 Nov;33(6):1105-16
references.pmid: 22903151
references.citation: Cancer. 2003 Jun 1;97(11):2919-25
references.pmid: 12767108
references.citation: Mol Biol Rep. 2013 Dec;40(12):6657-64
references.pmid: 24091943
references.citation: Oncol Nurs Forum. 2007 Sep;34(5):997-1005
references.pmid: 17878128
references.citation: BMC Public Health. 2009;9:421
references.pmid: 19922675
references.citation: Explore (NY). 2012 Mar-Apr;8(2):127-35
references.pmid: 22385567
references.citation: Psychooncology. 2005 Jan;14(1):70-8
references.pmid: 15386786
references.citation: Psychooncology. 2013 Jul;22(7):1517-27
references.pmid: 22936651
references.citation: Eur J Cancer Prev. 2006 Dec;15(6):541-7
references.pmid: 17106335
references.citation: J Am Diet Assoc. 1999 Oct;99(10):1212-21
references.pmid: 10524383
references.citation: J Natl Compr Canc Netw. 2014 Sep;12(9):1222-37
references.pmid: 25190692
references.citation: Oncol Nurs Forum. 2012 Jan;39(1):E31-40
references.pmid: 22201666
references.citation: Psychooncology. 2014 Oct;23(10):1133-41
references.pmid: 24700645
references.citation: Support Care Cancer. 2012 Jun;20(6):1235-42
references.pmid: 21688163
references.citation: Clin Breast Cancer. 2002 Dec;3 Suppl 3:S84-90
references.pmid: 12533268
references.citation: Oncol Nurs Forum. 2005 Nov;32(6):1151-63
references.pmid: 16270111
references.citation: World J Exp Med. 2013 Aug 20;3(3):34-42
references.pmid: 24520544
references.citation: Complement Ther Clin Pract. 2012 Feb;18(1):26-30
references.pmid: 22196570
references.citation: Nat Rev Cancer. 2007 Mar;7(3):192-201
references.pmid: 17318212
references.citation: J Gerontol A Biol Sci Med Sci. 2006 Nov;61(11):1166-70
references.pmid: 17167157