Prevalence and Predictors of Chemotherapy-Related Cognitive Impairment in Elderly Lung Cancer Patients: A Cross-Sectional Study

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior Pub Date : 2025-06-04 DOI:10.1002/brb3.70594

Wu XiuCen, Chen GuiHua, Li Qin, Tang Huan, Shen HuaPeng

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引用次数: 0

Abstract

Objective

To investigate the potential factors contributing to chemotherapy-related cognitive impairment in elderly lung cancer patients and to offer insights for the creation of an intervention program aimed at enhancing the cognitive abilities of this vulnerable population.

Methods

Three hundred thirty-eight lung cancer patients from the departments of respiratory medicine, oncology, and thoracic surgery of two tertiary-level hospitals in Chongqing from July 2023 to July 2024 were selected for the study via convenience sampling. A self-designed General and Disease-Related Information Questionnaire, Hospital Anxiety and Depression Scale (HADS), Brief Fatigue Inventory (BFI), Pittsburgh Sleep Quality Index (PSQI), Mini-Mental State Examination (MMSE), and Functional Assessment of Cancer Therapy Cognitive Function (Fact-Cog) were utilized for the questionnaire survey. Univariate analysis of variance and binary logistic regression were employed to analyze the factors influencing chemotherapy-related cognitive impairment in elderly lung cancer patients.

Results

Of the 338 participants, 300 (88.8%) were male and 38 (11.2%) were female, and 227 (67.2%) were between the ages of 60–69 years. The prevalence of cognitive impairment measured using the FACT-Cog was 32.8%, and univariate analysis revealed that homeplace, drinking, the nature of occupation before retirement, tea-drinking habits, leisure activities, ADL, pet ownership, HADS, BFI, PSQI, education level, hemoglobin value, and insurance were statistically significant (p < 0.05). Multifactorial analysis demonstrated that education level of junior high school (OR = 0.056, p < 0.05), education level of high school/secondary school (OR = 0.035, p < 0.05), education level of bachelor's degree/tertiary school (OR = 0.028, p < 0.05), and hemoglobin (OR = 0.981, p = 0.006) were protective factors for CRCI. Additionally, the nature of occupation before retirement (OR = 0.387, p = 0.005) and leisure activities (OR = 0.342, p = 0.001) were also found to be protective factors. Conversely, diagnosed anxiety-depression (OR = 2.938, p = 0.003) and severe fatigue (OR = 3.465, p = 0.001) emerged as risk factors for CRCI.

Conclusions

CRCI is the result of the intricate interplay of multiple potential factors and complex mechanisms. Healthcare professionals need to develop personalized intervention plans for patients based on their unique influencing factors, aiming to mitigate the adverse effects of risk factors on patients' cognitive functions. This approach can enhance patients' sense of self-worth and satisfaction with life, ultimately improving the quality of life of elderly lung cancer patients in the long term.

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老年肺癌患者化疗相关认知障碍的患病率和预测因素：一项横断面研究

目的探讨老年肺癌患者化疗相关认知功能障碍的潜在影响因素，为制定旨在提高老年肺癌患者认知能力的干预方案提供参考。方法选择2023年7月至2024年7月重庆市两家三级医院呼吸内科、肿瘤科和胸外科的肺癌患者338例，采用方便抽样的方法进行研究。采用自行设计的一般及疾病相关信息问卷、医院焦虑抑郁量表（HADS）、简易疲劳量表（BFI）、匹兹堡睡眠质量指数（PSQI）、简易精神状态检查（MMSE）和癌症治疗认知功能功能评估（Fact-Cog）进行问卷调查。采用单因素方差分析和二元logistic回归分析老年肺癌患者化疗相关认知功能障碍的影响因素。结果338名参与者中，男性300人（88.8%），女性38人（11.2%），年龄在60-69岁之间的227人（67.2%）。使用FACT-Cog测量的认知障碍患病率为32.8%，单变量分析显示，居住地、饮酒、退休前职业性质、饮茶习惯、休闲活动、ADL、养宠物、HADS、BFI、PSQI、教育水平、血红蛋白值和保险均具有统计学意义(p <；0.05)。多因素分析表明，初中学历水平(OR = 0.056, p <；0.05)，高中/中学文化程度(OR = 0.035, p <；0.05)，本科学历/大专学历(OR = 0.028, p <；0.05)，血红蛋白（OR = 0.981, p = 0.006）是CRCI的保护因素。此外，退休前的职业性质（OR = 0.387, p = 0.005）和休闲活动（OR = 0.342, p = 0.001）也被发现是保护因素。相反，诊断为焦虑抑郁（OR = 2.938, p = 0.003）和严重疲劳（OR = 3.465, p = 0.001）成为CRCI的危险因素。结论CRCI是多种潜在因素和复杂机制相互作用的结果。医疗保健专业人员需要根据患者独特的影响因素制定个性化的干预计划，旨在减轻危险因素对患者认知功能的不利影响。这种方式可以增强患者的自我价值感和对生活的满意度，最终提高老年肺癌患者的长期生活质量。

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来源期刊

Brain and Behavior BEHAVIORAL SCIENCES-NEUROSCIENCES

CiteScore

5.30

自引率

0.00%

发文量

352

审稿时长

14 weeks

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