Cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy: A longitudinal cohort study.
OBJECTIVE
Despite the well-known negative impacts of cancer and anticancer therapies on cognitive performance, little is known about the cognitive compensatory processes of older patients with cancer. This study was designed to investigate the cognitive compensatory processes of older, clinically fit patients with hematologic malignancies undergoing chemotherapy.


METHODS
We assessed 89 consecutive patients (age ≥ 65 y) without severe cognitive impairment and 89 age-, sex-, and education level-matched healthy controls. Cognitive compensatory processes were investigated by (1) comparing cognitive performance of patients and healthy controls in novel (first exposure to cognitive tasks) and non-novel (second exposure to the same cognitive tasks) contexts, and (2) assessing psychological factors that may facilitate or inhibit cognitive performance, such as motivation, psychological distress, and perceived cognitive performance. We assessed cognitive performance with the Trail-Making, Digit Span and FCSR-IR tests, psychological distress with the Hospital Anxiety and Depression Scale, and perceived cognitive performance with the FACT-Cog questionnaire.


RESULTS
In novel and non-novel contexts, average cognitive performances of healthy controls were higher than those of patients and were associated with motivation. Cognitive performance of patients was not associated with investigated psychological factors in the novel context but was associated with motivation and psychological distress in the non-novel context.


CONCLUSIONS
Older, clinically fit patients with hematologic malignancies undergoing chemotherapy demonstrated lower cognitive compensatory processes compared to healthy controls. Reducing distress and increasing motivation may improve cognitive compensatory processes of patients in non-novel contexts.
Université Libre de Bruxelles, Brussels, Belgium.
Yves
http://orcid.org/0000-0002-0909-0925
Y
Libert
Université Libre de Bruxelles, Brussels, Belgium.
Cindy
http://orcid.org/0000-0001-6385-6373
C
Borghgraef
Université de Liège, Liège, Belgium.
Yves
http://orcid.org/0000-0003-4650-7520
Y
Beguin
Université Libre de Bruxelles, Brussels, Belgium.
Nicole
http://orcid.org/0000-0002-1291-2301
N
Delvaux
Université de Liège, Liège, Belgium.
Martine
http://orcid.org/0000-0002-0224-862X
M
Devos
Université Catholique de Louvain, Yvoir, Belgium.
Chantal
http://orcid.org/0000-0002-8272-9158
C
Doyen
Université Libre de Bruxelles, Brussels, Belgium.
Stéphanie
http://orcid.org/0000-0001-6419-229X
S
Dubruille
Université de Liège, Liège, Belgium.
Anne-Marie
http://orcid.org/0000-0002-9497-1128
AM
Etienne
Université Libre de Bruxelles, Brussels, Belgium.
Aurore
http://orcid.org/0000-0002-4305-0425
A
Liénard
Université Libre de Bruxelles, Brussels, Belgium.
Isabelle
http://orcid.org/0000-0002-6321-5362
I
Merckaert
Université Catholique de Louvain, Yvoir, Belgium.
Christine
http://orcid.org/0000-0002-0866-8094
C
Reynaert
Université Libre de Bruxelles, Brussels, Belgium.
Jean-Louis
http://orcid.org/0000-0001-6881-7840
JL
Slachmuylder
Université Catholique de Louvain, Brussels, Belgium.
Nicole
http://orcid.org/0000-0003-0199-8821
N
Straetmans
Université Catholique de Louvain, Brussels, Belgium.
Eric
http://orcid.org/0000-0002-7846-4185
E
Van Den Neste
Université Libre de Bruxelles, Brussels, Belgium.
Dominique
http://orcid.org/0000-0002-1634-1104
D
Bron
Université Libre de Bruxelles, Brussels, Belgium.
Darius
http://orcid.org/0000-0001-6437-2020
D
Razavi
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001530:Belgium; D016022:Case-Control Studies; D003071:Cognition / Q000187:drug effects*; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011795:Surveys and Questionnaires
D000970:Antineoplastic Agents
cancer; chemotherapy; cognitive compensatory process; older; oncology