Trajectories of Cognitive Function and Associated Phenotypic and Genotypic Factors in Breast Cancer.
Catherine M Bender, John D Merriman, Susan M Sereika and 8 others
PMID 29683114WHAT IT FOUND
Some postmenopausal women with early-stage breast cancer had low scores in planning, concentration, or visual working memory before treatment, and some low trajectories persisted for 18 months.
Nurses can watch older age, fatigue, and baseline cognitive concerns.
Key findings
01Trajectory modeling identified low, moderate, and high groups for executive function and concentration, and low and high groups for visual working memory.
02Older age, lower estimated IQ, greater fatigue, poorer pretherapy cognitive performance, and treatment group were associated with lower cognitive trajectory group membership in multivariable models.
03In exploratory genetic analyses, DNA repair and oxidative stress gene variants were associated with trajectory group membership in some comparisons.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The genetic findings came from only 190 participants and were exploratory, so they cannot be used for clinical decisions. Most women were White, so results may not apply to other racial or ethnic groups. The paper says it is unclear whether the low trajectory scores meet criteria for cognitive impairment. It did not test interventions, so it does not show how to prevent or treat these cognitive changes. Practice effects may have influenced some improving trajectories.
Declared interests
No author conflict-of-interest or funding statement is included in the supplied text.
The easy way to misread this
Do not read this as proof that chemotherapy or anastrozole alone causes cognitive impairment. Some women also received surgery and radiation, and the study observed associations rather than isolating a treatment effect. It also states that it is unclear whether the low subgroup scores constitute impairment.