Perceived Cognitive Impairment in Breast Cancer Survivors and Its Relationships with Psychological Factors

Abstract

Cognitive complaints are common adverse effects in cancer patients. Identifying subjects at risk could make it possible to limit their impact. We aimed to explore the relationship between current cognitive complaints and demographic and psychological factors in a group of breast cancer survivors. Through an online survey, cancer survivors reported current cognitive complaints using the FACT-Cog questionnaire (Perceived Cognitive Impairment) and answered questions about their demographics, lifestyle and cancer-related characteristics. Anxiety, depression, fatigue and post-traumatic stress symptoms were also assessed. We used multivariable logistic regression models to explore the relationships between current cognitive complaints and social and psychological factors. Among the 1393 breast cancer survivors, 47.2% (n = 657) reported current cognitive complaints. Chemotherapy (OR = 2.26, 95%CI = 1.67-3.05), age (OR_{21-44 vs. >65} = 0.14, 95%CI = 0.07-0.27), sleep difficulties (OR_{never vs. often} = 2.41, 95%CI = 1.47-3.95), frequency of psychotropic treatments (OR_{never vs. >1/week} = 1.70, 95%CI = 1.23-2.36), post-traumatic stress symptoms (OR = 2.05, 95%CI = 1.57-2.69) and employment status (OR_{full-time or part-time vs. sick leave} = 1.64, 95%CI = 1.08-2.49) were strongly associated with current cognitive complaints. In this large study, about half of breast cancer survivors reported cognitive complaints, particularly after chemotherapy. Some risk factors should be detected early to reduce persistent cognitive complaints after cancer: mainly sleep difficulties, post-traumatic stress symptoms and psychotropic medications.

Keywords: breast cancer; cognitive complaints; post-traumatic stress.

Figure 1

Cancer-related treatments according to current cognitive complaints.

Figure 2

Significant psychological symptoms (anxiety, depression, fatigue and post-traumatic stress symptoms) according to current cognitive complaints. (Abbreviations = HADS: Hospital Anxiety and Depression Scale; IES-R: Impact of Event Scale-Revised; FACIT-F: Functional Assessment of Chronic Illness Therapy-Fatigue.).