Cognitive Impairment in a Subset of Breast Cancer Patients After Systemic Therapy-Results From a Longitudinal Study

Sanne Menning, Michiel B de Ruiter, Jacobien M Kieffer, Joost Agelink van Rentergem, Dick J Veltman, Agnetha Fruijtier, Hester S A Oldenburg, Epie Boven, Suzan van der Meij, Vera Lustig, Monique E M Bos, Willem Boogerd, Liesbeth Reneman, Sanne B Schagen

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

CONTEXT: Studies indicate adverse effects of breast cancer (BC) and cancer treatment on cognitive function.

OBJECTIVES: To investigate the effects of systemic treatment on cognitive performance in BC patients.

METHODS: Participants were BC patients scheduled to receive systemic treatment (BC + SYST; n = 31), or no systemic treatment (BC; n = 24) and no-cancer (NC) controls (n = 33). Neuropsychological examinations were used to study cognitive performance on 18 tests grouped into eight cognitive domains, before adjuvant treatment (T1) and six months after chemotherapy (T2), or at similar intervals. We also assessed health-related quality of life, anxiety and depression, mood, stress, and cognitive problems. Analysis of variance was used to assess group differences of cognitive performance and multivariate normative comparison to classify impairment, comparing scores of each participant against the distribution of the scores of NC controls.

RESULTS: Of BC + SYST, 16% were cognitively impaired at T2, compared to 4% in BC and 6% in NC. Although not significant, we observed moderate effect sizes for worse performance in the BC + SYST group compared to NC (Flanker congruent [effect size {ES} = 0.44] and stimulus incongruent [ES = 0.44]) and compared to BC (Controlled Oral Word Association Test [ES = 0.47], digit span [ES = 0.41], and Hopkins Verbal Learning Test immediate [ES = 0.71] and delayed recall [ES = 0.65]). Cognitively impaired patients had a significantly lower estimated premorbid intelligence, worse physical and social functioning, and more distress at T2 compared to unimpaired patients.

CONCLUSION: Our findings indicate that cognitive impairment after systemic treatment occurs in a subset of BC patients. The predictive value of demographic and psychosocial factors in cognitive impairment should be further investigated in a larger sample of impaired patients.

Original languageEnglish
Pages (from-to)560-569.e1
JournalJournal of Pain and Symptom Management
Volume52
Issue number4
DOIs
Publication statusPublished - 2016

Cite this

Menning, Sanne ; de Ruiter, Michiel B ; Kieffer, Jacobien M ; Agelink van Rentergem, Joost ; Veltman, Dick J ; Fruijtier, Agnetha ; Oldenburg, Hester S A ; Boven, Epie ; van der Meij, Suzan ; Lustig, Vera ; Bos, Monique E M ; Boogerd, Willem ; Reneman, Liesbeth ; Schagen, Sanne B. / Cognitive Impairment in a Subset of Breast Cancer Patients After Systemic Therapy-Results From a Longitudinal Study. In: Journal of Pain and Symptom Management. 2016 ; Vol. 52, No. 4. pp. 560-569.e1.
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title = "Cognitive Impairment in a Subset of Breast Cancer Patients After Systemic Therapy-Results From a Longitudinal Study",
abstract = "CONTEXT: Studies indicate adverse effects of breast cancer (BC) and cancer treatment on cognitive function.OBJECTIVES: To investigate the effects of systemic treatment on cognitive performance in BC patients.METHODS: Participants were BC patients scheduled to receive systemic treatment (BC + SYST; n = 31), or no systemic treatment (BC; n = 24) and no-cancer (NC) controls (n = 33). Neuropsychological examinations were used to study cognitive performance on 18 tests grouped into eight cognitive domains, before adjuvant treatment (T1) and six months after chemotherapy (T2), or at similar intervals. We also assessed health-related quality of life, anxiety and depression, mood, stress, and cognitive problems. Analysis of variance was used to assess group differences of cognitive performance and multivariate normative comparison to classify impairment, comparing scores of each participant against the distribution of the scores of NC controls.RESULTS: Of BC + SYST, 16{\%} were cognitively impaired at T2, compared to 4{\%} in BC and 6{\%} in NC. Although not significant, we observed moderate effect sizes for worse performance in the BC + SYST group compared to NC (Flanker congruent [effect size {ES} = 0.44] and stimulus incongruent [ES = 0.44]) and compared to BC (Controlled Oral Word Association Test [ES = 0.47], digit span [ES = 0.41], and Hopkins Verbal Learning Test immediate [ES = 0.71] and delayed recall [ES = 0.65]). Cognitively impaired patients had a significantly lower estimated premorbid intelligence, worse physical and social functioning, and more distress at T2 compared to unimpaired patients.CONCLUSION: Our findings indicate that cognitive impairment after systemic treatment occurs in a subset of BC patients. The predictive value of demographic and psychosocial factors in cognitive impairment should be further investigated in a larger sample of impaired patients.",
author = "Sanne Menning and {de Ruiter}, {Michiel B} and Kieffer, {Jacobien M} and {Agelink van Rentergem}, Joost and Veltman, {Dick J} and Agnetha Fruijtier and Oldenburg, {Hester S A} and Epie Boven and {van der Meij}, Suzan and Vera Lustig and Bos, {Monique E M} and Willem Boogerd and Liesbeth Reneman and Schagen, {Sanne B}",
note = "Copyright {\circledC} 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.",
year = "2016",
doi = "10.1016/j.jpainsymman.2016.04.012",
language = "English",
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Menning, S, de Ruiter, MB, Kieffer, JM, Agelink van Rentergem, J, Veltman, DJ, Fruijtier, A, Oldenburg, HSA, Boven, E, van der Meij, S, Lustig, V, Bos, MEM, Boogerd, W, Reneman, L & Schagen, SB 2016, 'Cognitive Impairment in a Subset of Breast Cancer Patients After Systemic Therapy-Results From a Longitudinal Study' Journal of Pain and Symptom Management, vol. 52, no. 4, pp. 560-569.e1. https://doi.org/10.1016/j.jpainsymman.2016.04.012

Cognitive Impairment in a Subset of Breast Cancer Patients After Systemic Therapy-Results From a Longitudinal Study. / Menning, Sanne; de Ruiter, Michiel B; Kieffer, Jacobien M; Agelink van Rentergem, Joost; Veltman, Dick J; Fruijtier, Agnetha; Oldenburg, Hester S A; Boven, Epie; van der Meij, Suzan; Lustig, Vera; Bos, Monique E M; Boogerd, Willem; Reneman, Liesbeth; Schagen, Sanne B.

In: Journal of Pain and Symptom Management, Vol. 52, No. 4, 2016, p. 560-569.e1.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Cognitive Impairment in a Subset of Breast Cancer Patients After Systemic Therapy-Results From a Longitudinal Study

AU - Menning, Sanne

AU - de Ruiter, Michiel B

AU - Kieffer, Jacobien M

AU - Agelink van Rentergem, Joost

AU - Veltman, Dick J

AU - Fruijtier, Agnetha

AU - Oldenburg, Hester S A

AU - Boven, Epie

AU - van der Meij, Suzan

AU - Lustig, Vera

AU - Bos, Monique E M

AU - Boogerd, Willem

AU - Reneman, Liesbeth

AU - Schagen, Sanne B

N1 - Copyright © 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

PY - 2016

Y1 - 2016

N2 - CONTEXT: Studies indicate adverse effects of breast cancer (BC) and cancer treatment on cognitive function.OBJECTIVES: To investigate the effects of systemic treatment on cognitive performance in BC patients.METHODS: Participants were BC patients scheduled to receive systemic treatment (BC + SYST; n = 31), or no systemic treatment (BC; n = 24) and no-cancer (NC) controls (n = 33). Neuropsychological examinations were used to study cognitive performance on 18 tests grouped into eight cognitive domains, before adjuvant treatment (T1) and six months after chemotherapy (T2), or at similar intervals. We also assessed health-related quality of life, anxiety and depression, mood, stress, and cognitive problems. Analysis of variance was used to assess group differences of cognitive performance and multivariate normative comparison to classify impairment, comparing scores of each participant against the distribution of the scores of NC controls.RESULTS: Of BC + SYST, 16% were cognitively impaired at T2, compared to 4% in BC and 6% in NC. Although not significant, we observed moderate effect sizes for worse performance in the BC + SYST group compared to NC (Flanker congruent [effect size {ES} = 0.44] and stimulus incongruent [ES = 0.44]) and compared to BC (Controlled Oral Word Association Test [ES = 0.47], digit span [ES = 0.41], and Hopkins Verbal Learning Test immediate [ES = 0.71] and delayed recall [ES = 0.65]). Cognitively impaired patients had a significantly lower estimated premorbid intelligence, worse physical and social functioning, and more distress at T2 compared to unimpaired patients.CONCLUSION: Our findings indicate that cognitive impairment after systemic treatment occurs in a subset of BC patients. The predictive value of demographic and psychosocial factors in cognitive impairment should be further investigated in a larger sample of impaired patients.

AB - CONTEXT: Studies indicate adverse effects of breast cancer (BC) and cancer treatment on cognitive function.OBJECTIVES: To investigate the effects of systemic treatment on cognitive performance in BC patients.METHODS: Participants were BC patients scheduled to receive systemic treatment (BC + SYST; n = 31), or no systemic treatment (BC; n = 24) and no-cancer (NC) controls (n = 33). Neuropsychological examinations were used to study cognitive performance on 18 tests grouped into eight cognitive domains, before adjuvant treatment (T1) and six months after chemotherapy (T2), or at similar intervals. We also assessed health-related quality of life, anxiety and depression, mood, stress, and cognitive problems. Analysis of variance was used to assess group differences of cognitive performance and multivariate normative comparison to classify impairment, comparing scores of each participant against the distribution of the scores of NC controls.RESULTS: Of BC + SYST, 16% were cognitively impaired at T2, compared to 4% in BC and 6% in NC. Although not significant, we observed moderate effect sizes for worse performance in the BC + SYST group compared to NC (Flanker congruent [effect size {ES} = 0.44] and stimulus incongruent [ES = 0.44]) and compared to BC (Controlled Oral Word Association Test [ES = 0.47], digit span [ES = 0.41], and Hopkins Verbal Learning Test immediate [ES = 0.71] and delayed recall [ES = 0.65]). Cognitively impaired patients had a significantly lower estimated premorbid intelligence, worse physical and social functioning, and more distress at T2 compared to unimpaired patients.CONCLUSION: Our findings indicate that cognitive impairment after systemic treatment occurs in a subset of BC patients. The predictive value of demographic and psychosocial factors in cognitive impairment should be further investigated in a larger sample of impaired patients.

U2 - 10.1016/j.jpainsymman.2016.04.012

DO - 10.1016/j.jpainsymman.2016.04.012

M3 - Article

VL - 52

SP - 560-569.e1

JO - Journal of Pain and Symptom Management

JF - Journal of Pain and Symptom Management

SN - 0885-3924

IS - 4

ER -