Self-reported cognitive function in older breast cancer survivors after chemotherapy treatment

Purpose

This study evaluated self-reported cognitive function in older breast cancer survivors and its association with prior chemotherapy.

Materials and methods

Breast cancer survivors aged 65-years and older, diagnosed 2012–2013, with local and regional stage disease, were identified through the linked Texas Cancer Registry-Medicare dataset. Survivors completed the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-CogV3) instrument and provided demographic and clinical data. A PCI--sub-score of less than 54 was used to identify cognitive impairment. Linear regression models were used to examine the FACT-CogV3 primary score, and logistic regression models evaluated the PCI--sub-score.

Results

Of 4448 eligible survivors, 1594 (35.8 %) completed the FACT-Cog and 1065 completed all questions. The median time from diagnosis to survey completion was 68 months The median age at survey completion was 76 years. 26 % of patients had received adjuvant chemotherapy. In adjusted models, decreased FACT-Cog primary scores were associated with age 80-years and older (p<0.01 vs. age 65–69) and with depression (p < 0.01), and increased scores were associated with an education of 4-year college and above (p = 0.01).

For the PCI-subscale, 243 patients (27.9 %) reported PCI-score <54. In the adjusted models, patients who were older than 80-years were more likely to report perceived cognitive impairment (OR 3.03, vs age 65–69), as well as those with depression (OR 6.19, p < 0.01). Prior chemotherapy was not a significant predictor of PCI (OR 1.49, p = 0.06).

Conclusion

Adjuvant chemotherapy was not significantly associated with self-reported cognitive impairment in older breast cancer survivors 5–6 years after diagnosis.