The target audience of this presentation is nurses who care for breast cancer patients and survivors and want better understanding of the relationship between self-reported cognitive abilities (language, visuo-perceptual, verbal memory, visual memory, and attention) and anxiety, depressive symptoms, and/or fatigue in breast cancer survivors

Crouch, Adele

Ofner, Susan

Von Ah, Diane

English

Sigma Repository

INTRODUCTIONPURPOSEDISCUSSIONACKNOWLEDGEMENTRESULTSMETHODSThe Association between Self-reported Cognitive Abilities and Commonly Reported Symptoms in Long-term Breast Cancer SurvivorsAdele Crouch BSN, RN, Susan Ofner, MS, and Diane Von Ah PhD, RN, FAANThe authors would like to acknowledge support from grant #64194 Robert Wood Johnson Foundation, Nurse Faculty Scholar (PI: D. Von Ah), Walther Cancer Institute #0155.01, (PI: D. Von Ah), American Cancer Society Doctoral Scholarship in Cancer Nursing, & National Cancer Institute #T32CA117865 (PI: V. Champion).This is a secondary data analysis of pooled baseline data from 2 independent IRB-approved studies.Inclusion criteria: 1) prior breast cancer diagnosis, 2) ≥ 1 year post initial treatment (except for tamoxifen or aromatase inhibitors), 3) ≥ 21 years of age, 4) stage I to IIIb, and 5) reporting some level of cognitive concerns. Data analysis: Descriptive statistics and linear regression were used to address the aims. Linear models and change point models were used to assess the associations of cognitive abilities and common symptoms (anxiety, depressive symptoms, fatigue), adjusting for age and education level.• 144 BCS were included in this study and were on average 54.4 (SD 8.8) years of age. • The majority of BCS were white (97.2%), married (66%), working full-time (59.7%), > 5 years post-treatment (5.1 years; SD 3.6), and well educated (some college - 15.6 years; SD 2.2). • Increased fatigue was associated with poorer total  cognitive abilities and all sub-domains (p<0.0001). • Increased anxiety was associated with poorer cognitive abilities (p=0.0105-<0.0001), except for visual memory, which had flattened relationship at 38 on the STAI-S. • Education level showed statistically significant negative correlations with cognitive ability (p=0.0377-<0.0008). • Increased depressive symptoms were significantly related to poorer cognitive abilities (p=0.0853-<0.0001); however, depressive symptom scores of ≥ about 5 had a different slope than those scores < 5. Depiction of these relationships is in Figure 1. • Increased levels of anxiety, depressive symptoms, and fatigue were associated with decrements in cognitive abilities. • We identified potential ‘cut points’ in the relationship between anxiety and visual memory and between depressive symptoms and multiple cognitive abilities domains. • The relationship between depression and the total scores on the MASQ and the sub-domains changed or flatted at a score of around 5 on the CES-D. This may indicate that after a certain level of depressive symptoms is met that the relationship with cognitive abilities is different.• This is important because if we could identify clinically significant scores.• If validated further these potential cut points could be used to screen BCS who may be more likely to have poorer cognitive abilities.• Results from his study can inform future BCS survivorship care planning, symptom management, and research.The purpose of this study was to examine the association between self-reported cognitive ability and commonly reported cancer symptoms of anxiety, depressive symptoms, and fatigue in BCS. • Breast cancer is the most commonly diagnosed cancer among women. • There are approximately 3.5 million breast cancer survivors (BCS) living in the United States. • BCS can be left facing detrimental symptoms long into survivorship. • We are interested in better understanding those commonly reported cancer symptoms.Measure Variable Meaning of ResultsFunctional Assessment of Cancer Therapy  Fatigue (FACT-F) Fatigue↑ scores reflect fewer problems with fatigueCenters for Epidemiologic Studies Depression Scale (CES-D)Depressive Symptoms↑ scores indicate more depressive symptomsSpielberger State Trait Anxiety Inventory (STAI) Anxiety↑ scores indicate more anxietyMultiple Abilities Questionnaire Self Ratings (MASQ) Domains: total cognitive ability, language, visuo-perceptual, verbal memory, visual memory, and attentionCognitive Ability↑ scores indicate greater cognitive disabilityTable 1. MeasuresRESULTS●●●●●●● ●●● ●●●●●●●●●●●●●●●●●●●●●●●● ● ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●●●●●●●●● ●●●●● ●●●●●● ●●●●● ●50751001251501750 10 20 30 40 50DepressionCognitive Ability●●●●●●●●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●●●●●10152025300 10 20 30 40 50DepressionLanguage●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●●●● ●●●●●●●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●●●●●●51015200 10 20 30 40 50DepressionVisuo−Perceptual●●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●● ●●●●●●●●●●●●●●●●●● ●●●●●●10152025300 10 20 30 40 50DepressionVerbal Memory●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●101520250 10 20 30 40 50DepressionVisual Memory●●●●●●●●●● ●●●●●●●●●●●●●●●●●●●●●●●●●● ●● ●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●●● ●●●●●●●●●●●● ●●●●●●●●●●●●10152025300 10 20 30 40 50DepressionAttentionKEY REFERENCESFigure 1. Depressive Symptoms and Cognitive Abilities Change Point Scatter Plots 1. Ahles, T. A., Saykin, A. J., McDonald, B. C., Furstenberg, C. T., Cole, B. F., Hanscom, B. S., ... & Kaufman, P. A. (2008). Cognitive function in breast cancer patients prior to adjuvant treatment. Breast cancer research and treatment, 110(1), 143-152.2. Seidenberg, M., Haltiner, A., Taylor, M. A., Hermann, B. B., & Wyler, A. (1994). Development and validation of a multiple ability self-report questionnaire. Journal of Clinical and Experimental Neuropsychology, 16(1), 093-104.3. Pullens, M. J., De Vries, J., & Roukema, J. A. (2010). Subjective cognitive dysfunction in breast cancer patients: a systematic review. Psycho-oncology, 19(11), 1127-1138.

The association between self-reported cognitive abilities and commonly reported symptoms in long-term breast cancer survivors

https://www.sigmarepository.org/cgi/viewcontent.cgi?article=3115&context=inrc

The association between self-reported cognitive abilities and commonly reported symptoms in long-term breast cancer survivors

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