Subjective assessment of cognitive function in the aging cancer patient: A URCC CCOP longitudinal study

Abstract

9631 Background: Unique challenges face elderly cancer survivors, including issues of quality of life. Impaired cognitive function is a common complaint among aging cancer patients. The purpose of this multicenter longitudinal study was to investigate the frequency and severity of self-reported problems with memory and concentration over time. Methods: Patients undergoing treatment for solid tumors self-rated problems with memory and concentration using an 11-point Likert Scale (0 = Not present to 10 = “As bad as you can imagine”) at baseline before treatment began (T1), at their worst during treatment (T2), and at 6 months following treatment (T3). Any symptom level ≥ 7 was classified as “severe.” Repeated measures analyses were used to examine differences in symptoms over time and between patients treated with and without chemotherapy. Results: Of 595 participants, 351 (59%) were aged ≤64 years and 244 (41%) were ≥65 years; 356 (60%) received chemotherapy, with or without radiation and 239 (40%) radiation alone. Concentration problems were reported by 40% (3% severe) of participants aged ≥65 at T1, 52% (7% severe) at T2 and 48% (4% severe) at T3. Memory loss was reported by 54% (3% severe) of participants aged ≥65 at T1, 58% (10% severe) at T2 and 59% (6% severe) at T3 (p < 0.0001). The average frequency and severity of both symptoms in patients receiving chemotherapy increased significantly between T1 and T2 (p<0.001). Both symptoms were less severe in patients receiving radiation alone at all three measurements (all ps<0.001). Symptoms at T3 were significantly higher than T1 for both groups (p<0.001) and all results were significantly worse when compared to those participants’ aged ≤64 (all ps<0.001). Conclusions: Self-reported problems with memory and concentration worsen with age in cancer patients undergoing chemotherapy and/or radiation. Prospective and objective assessments are needed to determine if cancer treatments are positively associated with cognitive decline, to identify the patients at risk, and to test appropriate interventions. Supported in part by a supplement from the Division of Cancer Control and Population Sciences, NCI, to Public Health Service grant U10 CA37420 and by NCI grant 1R25CA102618. No significant financial relationships to disclose.