Published online Feb 27, 2015.
https://doi.org/10.4040/jkan.2015.45.1.118
Prevalence and Characteristics of Chemotherapy-related Cognitive Impairment in Patients with Breast Cancer
Abstract
Purpose
Evidence suggests that some patients with breast cancer experience cognitive difficulties following chemotherapy. This longitudinal study was done to examine the prevalence of cognitive impairment and trajectory of cognitive function over time in women with breast cancer, who received adjuvant chemotherapy.
Methods
Participants were 137 patients with breast cancer. They completed neuropsychological tests and the Functional Assessment of Cancer Therapy-Cognitive Function before adjuvant therapy (pretest), toward the end of adjuvant therapy (posttest), and 6 months after the completion of adjuvant therapy (follow-up test). Of the patients, 91 were treated with adjuvant chemotherapy and 46 patients who did not receive chemotherapy made up the comparison group. A reliable-change index and repeated-measure ANOVA were used for statistical analyses.
Results
At the posttest point, over 30% of patients showed complex cognitive impairment and reported greater difficulty in subjective cognitive function. At the follow-up test point, 22.0% of patients exhibited complex cognitive impairment and 30.8% of patients complained of subjective cognitive impairment. Repeated-measure ANOVA showed significant decreases after receiving chemotherapy followed by small improvements 6 months after the completion of chemotherapy in cognitive domains of change for attention and concentration, memory, executive function, and subjective cognitive function.
Conclusion
These results suggest that chemotherapy in patients with breast cancer may be associated with objective and subjective cognitive impairments. Further studies are needed to explore the potential risk factors and predictor of chemotherapy-related cognitive changes. Also nursing interventions for prevention and intervention of cognitive impairments should be developed and tested.
Table 1
Homogeneity Tests between Chemotherapy Group and Comparison Group (N =137)
Table 2
Prevalence of Chemotherapy-Related Cognitive Impairment in Chemotherapy Group (N =91)
Table 3
Changes of Cognitive Function in Chemotherapy Group (N =91)
This work was supported by the National Research Foundation of Korea (KRF) funded by the Korea government (MEST) (2011-0012145).
References
-
Wagner LI, Sweet J, Butt Z, Lai JS, Cella D. Measuring patient self-reported cognitive function: Development of the functional assessment of cancer therapy-cognitive function instrument. J Support Oncol 2009;7(6):W32–W39.
-
-
Chelune GJ, Naugle RI, Lüders H, Sedlak J, Awad IA. Individual change after epilepsy surgery: Practice effects and base-rate information. Neuropsychology 1993;7(1):41–52. [doi: 10.1037/0894-4105.7.1.41]
-
-
Lezak MD, Howieson DB, Loring DW, Hannay J, Fischer JS. In: Neuropsychological assessment. 4th ed. New York, NY: Oxford University Press; 2004.
-
-
Moon S, Kim SH, Kim MJ. Perceived cognitive function and related factors in Korean women with breast cancer. Asian Nurs Res 2011;5(2):141–150. [doi: 10.1016/s1976-1317(11)60022-4]
-
-
Chung BY, Cho EJ. Correlates influencing cognitive impairment in breast cancer patients receiving chemotherapy. Asian Oncol Nurs 2012;12(3):221–229. [doi: 10.5388/aon.2012.12.3.221]
-