Abstract
Introduction
The relationship between cognitive function and frailty in older, long-term breast
cancer survivors was examined.
Materials and methods
Breast cancer survivors who were diagnosed and treated at 60 years of age or above
and were 5–15 year disease-free survivors and non-cancer controls matched on age and
education were evaluated with neuropsychological tests and the Comprehensive Geriatric
Assessment which was used to assess frailty based on a deficit accumulation frailty
index (DAFI).
Results
Unadjusted regression analyses revealed that cancer survivors scored significantly
lower on the Language (P = 0.015), Attention, Processing Speed, Executive Function (APE) (P = 0.015), and Learning and Memory (LM) (P = 0.023) domains compared to controls. However, only the LM domain remained significantly
different (P = 0.002) in the adjusted analysis. Survivors had significantly higher DAFI scores
compared to controls (p = 0.006) and significantly more survivors were categorized as pre-frail or frail
(35%) compared to controls (23%, P = 0.009). Increasing frailty scores were associated with worse cognitive performance
across all domains (all Ps ≤ 0.004). For the LM domain, there was a significant interaction (P = 0.019) between DAFI score and survivorship vs control status. Survivors demonstrated
a significant linear decline in LM scores as DAFI scores increased, whereas controls
demonstrated comparable scores between the robust and pre-frail DAFI groups, demonstrating
decline in the frailty group only.
Conclusion
Older, long-term breast cancer survivors had lower cognitive performance and higher
levels of frailty compared to controls. For the Learning and Memory domain, the decline
in performance began in the pre-frail range for survivors, but not controls.
Keywords
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Article info
Publication history
Published online: August 05, 2021
Accepted:
July 29,
2021
Received in revised form:
June 25,
2021
Received:
April 1,
2021
Identification
Copyright
© 2021 Elsevier Ltd. All rights reserved.
