Abstract P2-11-10: Prospective memory impairment in early breast cancer survivors: Finally homing in on the real deficit?

Abstract

Abstract Background There is still much debate about the impact of early breast cancer (EBC) treatment on memory functioning. One limitation of existing studies is that they are based on neuropsychological testing procedures which may not be sensitive enough to detect memory problems as encountered in daily life. In fact, no study has objectively assessed everyday memory performance in EBC. One crucial aspect of using memory in daily activities is to remember to do something at an appropriate time in the future without being asked to do so-defined as “prospective memory” (PM). Despite its importance for daily functioning, little is known about PM in EBC patients. Thus, we investigated whether EBC survivors who were within 1 year of having completed adjuvant chemotherapy have PM impairment in comparison to age-matched healthy controls. In addition, we evaluated the contributions of fatigue and depression to PM functioning. Methods We undertook a cross sectional quantitative case-control study (n = 80) comparing EBC patients from the Ottawa Hospital Regional Cancer Centre with age and education-matched healthy controls from the community. A standardized test of PM (Memory for Intention Screening Test) was administered to both groups. Impairment was defined as a score that fell 2 standard deviations below the mean performance of the control group. Standardized measures of depression (CESD) and fatigue (Fact-F) were also completed. Results Age was well balanced between the groups (case and control mean age 54y, p = .84). EBC patients performed more poorly than controls on the PM test (p < .001) and had a significantly higher rate of impairment (23% vs. 5%, McNemar χ2, p <.01, odds ratio=5.5, 95% CI=1.7745 to 17.1473). A series of hierarchical regressions showed that patients PM performance was affected by fatigue (p <.05), but not depression (p = .51). Conclusions The results demonstrate reduced memory performance in EBC survivors, with a specific impact on PM. Women who complain of ‘chemo fog’ should be evaluated carefully for PM deficits and their concerns should be acknowledged. An important finding from this study is the demonstration that fatigue is associated with memory deficits when memory as used in everyday life is evaluated. This finding which is suggestive of a common mechanism involved in fatigue symptoms and everyday memory disturbances raises the possibility that interventions targeted at improving fatigue may also improve memory functioning and quality of life in EBC survivors. Further longitudinal studies should be conducted to critically evaluate the role of chemotherapy by assessing PM before the initiation of chemotherapy and in EBC patients receiving only adjuvant hormonal therapy. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-10.