title: Relationship between self-reported and objectively measured physical activity and subjective memory impairment in breast cancer survivors: role of self-efficacy, fatigue and distress.
abstract: Many breast cancer survivors report cancer and cancer treatment-associated cognitive change. However, very little is known about the relationship between physical activity and subjective memory impairment (SMI) in this population. The purpose of this study is to examine the relationship between physical activity and SMI and longitudinally test a model examining the role of self-efficacy, fatigue and distress as potential mediators.
  
  
  
  Post-treatment breast cancer survivors (N = 1477) completed measures of physical activity, self-efficacy, distress (depression, concerns about recurrence, perceived stress, anxiety), fatigue and SMI at baseline and 6-month follow-up. A subsample (n = 362) was randomly selected to wear an accelerometer. It was hypothesized that physical activity indirectly influences SMI via exercise self-efficacy, distress and fatigue. Relationships were examined using panel analysis within a covariance modeling framework.
  
  
  
  The hypothesized model provided a good fit in the full sample (χ2= 1462.5, df = 469, p = <0.001; CFI = 0.96; SRMR = 0.04) and the accelerometer subsample (χ2 = 961.8, df = 535, p = <0.001, CFI = 0.94, SRMR = 0.05) indicating increased physical activity is indirectly associated with reduction in SMI across time, via increased exercise self-efficacy and reduced distress and fatigue.
  
  
  
  Higher levels of physical activity, lower levels of fatigue and distress and higher exercise self-efficacy may play an important role in understanding SMI in breast cancer survivors across time. Future research is warranted to replicate and explore these relationships further. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Siobhan M
authors.initials: SM
authors.lastname: Phillips
authors.affiliation: Department of Preventive Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Gillian R
authors.initials: GR
authors.lastname: Lloyd
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Urbana, IL, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Awick
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois Urbana Champaign, Urbana, IL, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: McAuley
mesh_terms: D000328:Adult; D001007:Anxiety / Q000517:prevention & control; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation; D000073116:Cancer Survivors / Q000523:psychology*; D015444:Exercise / Q000523:psychology; D005221:Fatigue / Q000523:psychology; D005260:Female; D006801:Humans; D008569:Memory Disorders / Q000209:etiology* / Q000517:prevention & control*; D008875:Middle Aged; D009043:Motor Activity; D011788:Quality of Life / Q000523:psychology; D020377:Self Efficacy
keywords: distress; fatigue; physical activity; selfefficacy; subjective memory impairment