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. 2022 Jan;13(1):27-32.
doi: 10.1016/j.jgo.2021.07.011. Epub 2021 Aug 5.

Relationship between cognitive functioning and frailty in older breast cancer survivors

Tim A Ahles  1 , Elizabeth Schofield  2 , Yuelin Li  2 , Elizabeth Ryan  2 , James C Root  2 , Sunita K Patel  3 , Katrazyna McNeal  2 , Alexandra Gaynor  2 , Heidi Tan  3 , Vani Katheria  3 , Jessica Vazquez  3 , Tiffany Traina  4 , Arti Hurria  5
Affiliations

Relationship between cognitive functioning and frailty in older breast cancer survivors

Tim A Ahles et al. J Geriatr Oncol. 2022 Jan.

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: Cognition frailty; Older breast cancer survivor.

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Conflict of interest statement

Declaration of Competing Interest The authors have no conflicts of interest to disclose.

Figures

Figure 1:
Figure 1:
Interaction of Frailty Categorization and Survivor vs. Control Status for the Learning and Memory Domain
See this image and copyright information in PMC

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