Accounting for unmet needs resulting from cancer-related cognitive impairment.

Abstract

Purpose: Cancer-related cognitive impairment (CRCI) causes a wide range of unmet needs for cancer survivors. It is unknown which clinical, demographic, cognitive, and psychological factors underpin and account for these various unmet needs. This study aimed to (a) identify factors associated with CRCI-related unmet needs, and (b) establish the most pertinent factors that account for CRCI-related unmet needs.

Methods: Four hundred and fifty-six (n = 456) cancer survivors responded to a range of demographic and clinical questions, as well as measures of CRCI-related unmet needs (MASCC COG-IMPACT), perceived cognitive impairment (PROMIS-COG), and psychological distress (DASS-21). Descriptive statistics, bivariate correlations, and feed-forward multiple regression analyses were completed.

Results: Cognitive impairment severity (r = 0.39 to 0.59; p < 0.01), psychological distress (r = 0.36 to 0.58; p < 0.01), and time since diagnosis (r =  - 0.11 to - 0.20; p < 0.05 to p = 0.02) were significantly associated with CRCI-related unmet needs across all domains. Age (r =  - 0.10 to - 0.22; p < 0.001 to p = 0.03), stage of cancer at initial diagnosis (r = 0.10 to 0.13; p < 0.001 to p = 0.04), stage of cancer at most progressed (r = 0.11 to 0.18; p < 0.001 to p = 0.03), and sex (r = 0.12; p = 0.01; females experiencing greater unmet needs than males), were significantly associated with one or more domains of unmet need. Cognitive impairment severity and psychological distress were the most pertinent factors accounting for CRCI-related unmet needs (R² = 0.245, F_{(3, 487)} = 48.96, p < 0.001 to R² = 0.474, F_{(3, 487)} = 114.81, p < 0.001), explaining 24.5% to 47.4% of the variance.

Conclusion: Cognitive impairment severity and psychological distress were the most key factors in accounting for CRCI-related unmet needs. Other variables, while associated with CRCI-related unmet needs, did not provide additional predictive utility.

Implications for cancer survivors: The results may inform the choice of supportive care targets, and future strategies, to improve supportive care for people experiencing cancer-related cognitive impairment.