Age-related differences in self-report and objective measures of cognitive function in older patients prior to chemotherapy.
Inger Utne, Borghild Løyland, Ellen Karine Grov and 8 others
PMID 34878233WHAT IT FOUND
Around the start of chemotherapy, patients aged ≥70 took longer on a task-switching test than patients aged 60-69, while other cognitive scores were similar.
Age alone did not separate groups on most measures.
Key findings
01The ≥70 group had worse Trail Making Test B scores than the 60-69 group, while MoCA and self-report scores did not differ.
02Compared with general population norms, the 60-69 group scored worse on all objective cognitive tests, including Trail Making Test B, where the authors reported a large effect size (d = 1.27).
03Correlations between self-reported cognitive function and objective scores were r = .21 to r = .28, and TMT A did not correlate with either self-report score.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show how cognitive function changed over time or whether chemotherapy caused any decline. The sample was mostly women with gynecological cancer, so the results may not apply to other cancer types or to men. Patients needed a MoCA score of ≥23 and a Karnofsky Performance Status score of ≥60, so people with more obvious cognitive or functional impairment were not included. The two age groups were relatively small, even though the total sample was 139. Tests were done before, on the same day as, or immediately after the first chemotherapy infusion, so timing was not uniform. The authors could not compare participants with patients who declined, because ethics rules prevented collecting that information.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the worse Trail Making Test B score in the older group as proof that chemotherapy caused cognitive decline or that all older patients are impaired around the start of treatment. The study was cross-sectional, patients were selected to have MoCA scores of ≥23, and most cognitive measures did not differ between age groups.