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Cognitive impairment in adolescent and young adult cancer patients: Pre-treatment findings of a longitudinal study.


ABSTRACT:

Background

There is little information about cancer-related cognitive impairment (CRCI) in adolescent and young adults (AYA, 15-39 years old) due to its rare incidence. Here, we present the pre-treatment (before chemotherapy or radiotherapy) evaluation of cognitive function and ability of AYA with cancer (AYAC) in a multicentered cohort study.

Methods

Newly diagnosed AYAC and age-matched healthy controls (HC) were recruited between 2018 and 2021. The primary outcome was the comparison of pre-treatment cognitive impairment defined as 2 standard deviations (SDs) below the HC on ≥1 cognitive test, or >1.5 SDs below on ≥2 tests using CANTAB® between AYAC and HC. Secondary outcomes included self-perceived cognitive ability assessed by FACT-Cog v3 and biomarkers (inflammatory cytokines and brain-derived neurotrophic factor [BDNF]).

Results

We recruited 74 AYAC (median age = 34) and 118 HC (median age = 32). On objective cognitive testing, we observed three times more AYAC patients performed poorly on at least 2 cognitive tests compared to HC (40.5% vs. 13.6%, p < 0.001). AYAC self-perceived less degree of cognitive impairment than HC (p < 0.001). However, AYAC perceived a greater impact of cognitive changes on their quality of life compared to HC (p = 0.039). Elevated baseline inflammatory markers (IL-2, IL-4, IL-6, IL-8, IL-10 and IFN-γ) were observed among AYAC compared to HC, and baseline BDNF was lower in AYAC compared to HC. Interaction effects between cancer diagnosis and biomarkers were observed in predicting cognitive function.

Conclusion

With the pre-existence of CRCI and risk factors of neuroinflammation even prior to systemic therapy, AYAC should receive early rehabilitation to prevent further deterioration of cognitive function after initiation of systemic therapies. (ClinicalTrials.gov Identifier: NCT03476070).

SUBMITTER: Chan A 

PROVIDER: S-EPMC9972136 | biostudies-literature | 2023 Feb

REPOSITORIES: biostudies-literature

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Publications

Cognitive impairment in adolescent and young adult cancer patients: Pre-treatment findings of a longitudinal study.

Chan Alexandre A   Cheng Ivy I   Wang Claire C   Tan Chia Jie CJ   Toh Yi Long YL   Ng Ding Quan DQ   Koh Yong Qin YQ   Zhou Hanzhang H   Foo Koon Mian KM   Chan Raymond Javan RJ   Ho Han Kiat HK   Chew Lita L   Farid Mohamad M   Tannock Ian I  

Cancer medicine 20221011 4


<h4>Background</h4>There is little information about cancer-related cognitive impairment (CRCI) in adolescent and young adults (AYA, 15-39 years old) due to its rare incidence. Here, we present the pre-treatment (before chemotherapy or radiotherapy) evaluation of cognitive function and ability of AYA with cancer (AYAC) in a multicentered cohort study.<h4>Methods</h4>Newly diagnosed AYAC and age-matched healthy controls (HC) were recruited between 2018 and 2021. The primary outcome was the compar  ...[more]

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