Cognitive function prior to systemic therapy and subsequent well-being in older breast cancer survivors: Longitudinal findings from the Thinking and Living with Cancer Study

Lindsay C. Kobayashi, Harvey Jay Cohen, Wanting Zhai, Xingtao Zhou, Brent J. Small, George Luta, Arti Hurria, Judith Carroll, Danielle Tometich, Brenna C. McDonald, Deena Graham, Heather S.L. Jim, Paul Jacobsen, James C. Root, Andrew J. Saykin, Tim A. Ahles, Jeanne Mandelblatt

Research output: Contribution to journalArticle

Abstract

Objective: To investigate the relationships between self-reported and objectively measured cognitive function prior to systemic therapy and subsequent well-being outcomes over 24 months in older breast cancer survivors. Methods: Data were from 397 women aged 60 to 98 diagnosed with non-metastatic breast cancer in the Thinking and Living with Cancer Study recruited from 2010-2016. Cognitive function was measured at baseline (following surgery, prior to systemic therapy) using neuropsychological assessments of attention, processing speed, and executive function (APE), learning and memory (LM), and the self-reported FACT-Cog scale. Well-being was measured using the FACT-G functional, physical, social, and emotional well-being domain scales at baseline and 12 and 24 months later, scaled from 0 (low) to 100 (high). Linear mixed-effects models assessed the relationships between each of baseline APE, LM, and FACT-Cog quartiles with well-being scores over 24 months, adjusted for confounding variables. Results: At baseline, older survivors in the lowest APE, LM, and FACT-Cog score quartiles experienced poorer global well-being than those in the highest quartiles. At 24 months, older survivors tended to improve in well-being, and there were no differences according to baseline APE or LM scores. At 24 months, mean global well-being was 80.3 (95% CI: 76.2-84.3) among those in the lowest vs 86.6 (95% CI: 83.1-90.1) in the highest FACT-cog quartile, a clinically meaningful difference of 6.3 points (95% CI: 1.5-11.1). Conclusions: Among older breast cancer survivors, self-reported, but not objective cognitive impairments, were associated with lower global well-being over the first 2 years of survivorship.

Original languageEnglish (US)
Pages (from-to)1051-1059
Number of pages9
JournalPsycho-Oncology
Volume29
Issue number6
DOIs
StatePublished - Jun 1 2020

Keywords

  • aging
  • breast cancer
  • cancer
  • cancer survivors
  • cognitive function
  • oncology
  • quality of life
  • self-reports
  • well-being

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Oncology
  • Psychiatry and Mental health

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  • Cite this

    Kobayashi, L. C., Cohen, H. J., Zhai, W., Zhou, X., Small, B. J., Luta, G., Hurria, A., Carroll, J., Tometich, D., McDonald, B. C., Graham, D., Jim, H. S. L., Jacobsen, P., Root, J. C., Saykin, A. J., Ahles, T. A., & Mandelblatt, J. (2020). Cognitive function prior to systemic therapy and subsequent well-being in older breast cancer survivors: Longitudinal findings from the Thinking and Living with Cancer Study. Psycho-Oncology, 29(6), 1051-1059. https://doi.org/10.1002/pon.5376