ASPO Abstracts
Cognitive complaints and longitudinal quality of life in older breast cancer survivors: findings from the Thinking and Living with Cancer Study
Category: Survivorship & Health Outcomes/Comparative Effectiveness Research
Conference Year: 2019
Abstract Body:
Purpose: Cognitive complaints increase in frequency with aging and are sometimes reported by breast cancer survivors, but the effects of cognitive problems on multiple dimensions of quality of life among older survivors are unknown. We investigated the relationships between self-reported cognitive function and quality of life (QOL) in older survivors.Methods: Data were from 344 women aged 60-98 with non-metastatic breast cancer in the multi-site Thinking and Living with Cancer Study recruited from 2010-2015. Cognitive complaints following surgery and before systemic therapy (baseline) were measured using the FACT-Cog scale. QOL was measured using the FACT functional, physical, social, and emotional scales at baseline and 12- and 24-months later, scaled to be from 0-100 with higher scores representing better QOL. Linear mixed effects models assessed the relationships between baseline FACT-Cog score quartile and QOL domain scores over 24 months, adjusted for age, race, education, comorbidities, anxiety, depression, treatment modality, and study site. Results: Survivors in the lowest quartile of self-reported cognition had worse functional, physical, and emotional well-being at baseline than survivors in the highest cognition quartile. For example, adjusted mean physical wellbeing was 71.4 (95% CI: 67.4-75.4) vs. 85.8 (95% CI: 81.7-89.8) for the lowest vs. highest self-reported cognition quartile. Poor baseline self-reported cognition remained associated with worse physical well-being at the 24-month follow-up: adjusted mean physical well-being = 76.7 (95% CI: 72.0-81.4) vs. 84.8 (95% CI: 80.1-89.6) for lowest vs. highest quartile. Regardless of self-reported cognition, average functional and emotional well-being improved, but social well-being worsened for survivors over time.Conclusions: Older breast cancer survivors with greater cognitive complaints prior to systemic therapy have persistently physical function than those with fewer complaints over a two-year follow-up. Cognitive complaints may be a marker of survivors needing surveillance or intervention. Future work should investigate the potentially reciprocal relationships between cognition (self-reported and according to neuropsychological tests) and physical function in older breast cancer survivors.
Keywords: cognitive function; breast cancer; survivorship; aging; quality of life