Complications of TreatmentObjective and subjective cognitive impairment following chemotherapy for cancer: A systematic review
Section snippets
Objective Measures of Cognitive Impairment Following Chemotherapy for Cancer
Cognitive function following chemotherapy, measured objectively through neuropsychological tests, has received considerable attention.1, 4, 5, 6Research using neuropsychological tests indicates that chemotherapy affects many domains of cognition, including executive function, processing speed, attention/concentration, and verbal and visual memory.1, 7, 8 Anderson-Hanley et al.’s meta-analysis of the results of 30 studies suggests that the domains of memory and executive function are
Subjective Measures of Cognitive Impairment Following Chemotherapy for Cancer
Perceived cognitive impairment, measured using self-report questionnaires or interviews, is arguably as important as objective impairment because it assesses the impact of cognitive impairment on individuals’ lives and daily functioning.13 When interviewed immediately following chemotherapy and up to 12 months after treatment completion, many patients with cancer report changes in their memory and attention, and describe particular difficulties with multi-tasking and making decisions in daily
Search Strategy and Selection Criteria
The following MEDLINE and PubMed search was conducted on April 5, 2012: cancer AND chemotherapy AND (cognitive OR cognition) AND (assessment OR objective OR neuropsychological OR neuropsychology OR subjective OR self-report). Other relevant articles were sourced from the reference lists of included papers. The search was limited to human studies, papers published in English, and studies published after 1980, when studies began to report prevalence of both perceived cognitive impairment and
Studies Comparing Perceived (Subjective) Impairment and Neuropsychological (Objective) Assessments of Cognition
It is well established that chemotherapy patients often perceive deficits in their cognitive functioning and that such perceptions are related to quality of life, anxiety, depression and fatigue. However, studies that assess the relationship between objective neuropsychological test performance and self-reported cognitive difficulties have found small or non-significant associations.1, 2, 12, 19 Table 1 summarises the studies that have examined both self-reported cognitive impairment and more
Discussion
Impaired cognitive function following chemotherapy treatment for cancer has been well documented and it is estimated that some degree of difficulty is experienced by 15% to 50% of patients with solid tumours. Perceived impairment is more common than objectively confirmed impairment and, within patient samples, there is often little or no association between the two. This was consistent with the current review, which only found an association in one third of included studies. Studies were more
Summary and Recommendations for Future Research
To the extent that some studies report an association between subjective experience and objective measures, whereas others do not, it is possible that the association is only evident where both can be linked to objective reports of difficulties with everyday problems. Unfortunately, these are rarely measured notwithstanding the existence of scales like the Everyday Problems Test (EPT)45. Future research should examine the extent to which concordance between objective neuropsychological measures
Conflict of Interest Statement
There are no conflicts of interest to declare for any of the authors.
References (45)
- et al.
Cognitive function after chemotherapy in adults with solid tumours
Crit Rev Oncol Hematol
(2007) - et al.
The association between neuropsychological impairment, self-perceived cognitive deficits, fatigue and health related quality of life in breast cancer survivors following standard adjuvant versus high-dose chemotherapy
Patient Educ Couns
(2007) - et al.
Cancer and cancer-therapy related cognitive dysfunction: an international perspective from the Venice cognitive workshop
Ann Oncol
(2008) - et al.
Self-reported cognitive problems in women receiving adjuvant therapy for breast cancer
Eur J Oncol Nurs
(2007) - et al.
Cognitive dysfunction and subjective complaints of cancer patients. A cross-sectional study in a cancer rehabilitation centre
Eur J Cancer
(2004) - et al.
Late effects of adjuvant chemotherapy on cognitive function: a follow-up study in breast cancer patients
Ann Oncol
(2002) - et al.
The effects of adjuvant chemotherapy on cognition in women with breast cancer–preliminary results of an observational longitudinal study
Breast
(2005) - et al.
Self-reported cognitive problems in testicular cancer patients: relation to neuropsychological performance, fatigue, and psychological distress
J Psychosom Res
(2011) - et al.
Giving meaning to measure: linking self-reported fatigue and function to performance of everyday activities
J Pain Symptom Manage
(2006) - et al.
Subjective cognitive dysfunction in breast cancer patients: a systematic review
Psychooncology
(2010)
Cognitive effects of standard-dose chemotherapy in patients with cancer
Cancer Invest
Low neuropsychologic performance among adult cancer survivors treated with chemotherapy
Curr Neurol Neurosci Rep
Chemotherapy-related change in cognitive function: a conceptual model
Oncol Nurs Forum
Neuropsychological effects of treatments for adults with cancer: a meta-analysis and review of the literature
J Int Neuropsychol Soc
Cognitive impairment associated with chemotherapy for cancer: report of a workshop
J Clin Oncol
The impact of different definitions and reference groups on the prevalence of cognitive impairment: a study in postmenopausal breast cancer patients before the start of adjuvant systemic therapy
Psychooncology
What do perceived cognitive problems reflect?
J Support Oncol
A 3-year prospective study of the effects of adjuvant treatments on cognition in women with early stage breast cancer
Br J Cancer
Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy
J Natl Cancer Inst
Self-reported cognitive impairment in patients with cancer
J Oncol Pract
Cognitive and psychological factors associated with early posttreatment functional outcomes in breast cancer survivors
J Psychosoc Oncol
Evaluation of cognitive function associated with chemotherapy: a review of published studies and recommendations for future research
J Clin Oncol
Cited by (334)
Understanding experiences of cognitive decline and cognitive assessment from the perspectives of people with glioma and their caregivers: A qualitative interview study
2024, International Journal of Nursing Studies AdvancesThe acute psychological effects of screen time and the restorative potential of nature immersion amongst adolescents: A randomised pre-post pilot study
2023, Journal of Environmental PsychologyTooth loss, body mass index and cognitive function among middle-aged and older adults in China: Does gender matter?
2023, Journal of Affective DisordersSenolytic treatment alleviates doxorubicin-induced chemobrain
2024, Aging CellPrevalence and associated factors of chemotherapy-related cognitive impairment in older breast cancer survivors
2024, Journal of Advanced Nursing