Cognitive difficulties among patients with cancer receiving chemotherapy affects quality of life: A University of Rochester Clinical Community Oncology Program study of 439 patients.

Abstract

9119 Background: Cognitive difficulties affect up to 75% of cancer patients receiving chemotherapy, and these difficulties linger in up to 35% of survivors years after treatment. The extent to which cognitive difficulties affect quality of life (QOL) in patients receiving chemotherapy is not well-understood. Methods: We examined levels of memory and concentration difficulty in 439 patients undergoing chemotherapy who were enrolled in a randomized trial assessing effects of modafinil on cancer-related fatigue conducted through the University of Rochester Clinical Community Oncology Program (CCOP). Memory and concentration were assessed via the Fatigue Symptom Checklist (FSCL) from those that completed the measure at cycles 2, 3, and 4 of chemotherapy. QOL (i.e., general activity, mood, normal work, and enjoyment of life) items were assessed by the Brief Fatigue Inventory (BFI). Spearman’s rho correlations were used to determine the strength of the relationship between cognitive function and QOL. Logistic regression was used to predict associations between memory and concentration at cycle 2 and 3 with cycle 4 and was also used to predict associations between memory and concentration difficulty at cycle 2 with interference in QOL at cycle 4. Results: Concentration and memory difficulty at cycles 2 and 3 were both significant predictors of concentration and memory difficulty at cycle 4 (OR range=1.94 to 9.08; all p <0.05). At cycles 2, 3, and 4, problems with memory and concentration were significantly correlated with interference in all QOL items assessed (r values range=0.160 to 0.365, all p <0.05). Concentration difficulty at cycle 2 was significantly predictive of interference in all QOLs items at cycle 4 (OR range=2.23 to 3.34; all p <0.05). Memory difficulty at cycle 2 was only significantly predictive of interference in mood at cycle 4 (OR=2.05, p <0.05) and not other items (OR range=1.33 to 2.13; p >0.05). Conclusions: Our results suggest that cognitive difficulties in cancer patients receiving chemotherapy are associated with reductions in QOL. Further research on the long-term effects of cognitive difficulties on QOL are needed.