title: Self-reported memory problems in adult-onset cancer survivors: effects of cardiovascular disease and insomnia.
abstract: BACKGROUND
  Cancer and its treatments can deleteriously affect memory. Cardiac function and insomnia can exacerbate memory problems.
  
  
  OBJECTIVE
  To examine the relationships among cardiovascular disease, insomnia, and self-reported memory problems (SRMP) in adult-onset cancer survivors.
  
  
  METHODS
  We included data from participants (41-64 year-old) of the 2007-2008 National Health and Nutrition Examination Survey, a nationally representative probability sample of the civilian, non-institutionalized population of the US. We excluded participants with brain cancer/stroke history since these conditions are expected to cause cognitive problems. Using binary logistic regression, we determined the prevalence of SRMP relative to cardiac problems and insomnia by weighting our results proportionally. We adjusted for predictors of memory problems: age, sex, race, education and general health.
  
  
  RESULTS
  The sample included 2289 adults (49% females), 9% with a cancer history. The results pertain only to cancer survivors. Those with insomnia were 16 times as likely to have SRMP. Only insomnia symptoms (OR, 15.74; 95% CI, 1.73-143.30; p < 0.01) significantly predicted SRMP, uniquely explaining 12% of the variance. Insomnia accounted for 18.8% of the association between cardiac issues and SRMP, demonstrating mediation (Sobel p < 0.05). The large CI is a consequence of analyzing a sub-group of a subpopulation. Among participants without a cancer history, cardiovascular disease and insomnia were not associated with SRMP (p > 0.05).
  
  
  CONCLUSIONS
  We could not determine severity and time-related changes in SRMP.
  
  
  CONCLUSIONS
  Likelihood of SRMP was higher in cancer survivors with a history of cardiovascular disease and insomnia symptoms. Future studies are needed to delineate the cardiac-insomnia-memory interrelationships.
authors.affiliation: Department of Psychology, Neurocognitive Translational Research Lab, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, USA; Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, IN, USA. Electronic address: PJeanPierre@ND.edu.
authors.forename: Pascal
authors.initials: P
authors.lastname: Jean-Pierre
authors.affiliation: Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, PA, USA; Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grandner
authors.affiliation: Department of Psychiatry, Behavioral Sleep Medicine Program, University of Pennsylvania, Philadelphia, PA, USA; Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Sheila N
authors.initials: SN
authors.lastname: Garland
authors.affiliation: Department of Hematology/Oncology, Cardinal Bernardin Cancer Center, Loyola University Medical Center, Maywood, IL, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Henry
authors.affiliation: Department of Population Health, Center for Healthful Behavior Change, New York University, New York, NY, USA.
authors.forename: Girardin
authors.initials: G
authors.lastname: Jean-Louis
authors.affiliation: Department of Psychology, Neurocognitive Translational Research Lab, Harper Cancer Research Institute, University of Notre Dame, Notre Dame, IN, USA.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Burish
mesh_terms: D000328:Adult; D000647:Amnesia / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology*; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology; D018450:Disease Progression; D005260:Female; D006331:Heart Diseases / Q000139:chemically induced / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy*; D009749:Nutrition Surveys; D012650:Self Disclosure; D007319:Sleep Initiation and Maintenance Disorders / Q000139:chemically induced / Q000150:complications* / Q000453:epidemiology; D017741:Survivors / Q000706:statistics & numerical data; D014481:United States
chemical_list: D000970:Antineoplastic Agents
keywords: Cancer and memory problems; Cardiovascular disease; Chemobrain; Sleep problems