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. 2025 Oct-Dec;25(4):100626.
doi: 10.1016/j.ijchp.2025.100626. Epub 2025 Sep 24.

Optimism, sleep quality, physical activity, and cancer-related cognitive impairment in middle-to-older aged patients undergoing breast cancer treatment

Jenna L Hansen  1 , Rachel Plotke  1 , Millan R Kanaya  1 , Sarah N Webster  1 , Paula J Popok  1 , Emily A Walsh  2   3 , Molly Ream  1   4 , Mason J Krueger  1 , Estefany Saez-Clarke  1 , Dolores M Perdomo  5 , Daniela Frasca  6   7 , Susan B Kesmodel  7   8 , Bonnie B Blomberg  6   7 , Michael H Antoni  1   5   7
Affiliations

Optimism, sleep quality, physical activity, and cancer-related cognitive impairment in middle-to-older aged patients undergoing breast cancer treatment

Jenna L Hansen et al. Int J Clin Health Psychol. 2025 Oct-Dec.

Abstract

Background: Patients with breast cancer (BC) are at risk for cancer-related cognitive impairment (CRCI) due to BC-related stress and cancer treatment. Optimism and positive health behaviors may mitigate CRCI. This study examined relationships between optimism, health behaviors (sleep quality and physical activity) and CRCI in BC patients during the post-surgical period and whether optimism and health behaviors interacted in this relationship.

Methods: Women with recently diagnosed BC enrolled in a stress management trial following BC surgery. At baseline, participants completed questionnaires that measured CRCI, optimism, sleep quality, and physical activity.

Results: 79 patients were enrolled (M = 61 years; range=50-85). Multiple regression models controlling for patient age, stage, surgery type, body mass index, and comorbidities revealed that optimism was associated with fewer perceived cognitive impairments (β=0.32, p=.01) and greater perceived cognitive abilities (β=0.38, p=.001). Poorer sleep quality was associated with poorer perceived cognitive abilities (β =-0.37, p=.01) and greater impact of cognitive impairments on quality of life (β=-0.39, p=.01). Moderation models revealed an interaction between optimism and sleep quality on perceived cognitive impairments (β=2.06, p=.02), such that among those low in optimism, poorer sleep quality was associated with greater perceived cognitive impairments (b=-2.42, p=.01) but not among those with high optimism (p=.46). No other models were statistically significant.

Conclusions: Results suggest that optimism and sleep quality may be associated with better cognitive function in BC patients in the post-surgical period. Interventions that improve optimistic expectancies and sleep quality may help to mitigate CRCI in mid-to-older BC patients initiating treatment.

Keywords: Aging; Breast cancer; Cancer-related cognitive impairment; Optimism; Physical activity; Sleep Quality.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests Michael Antoni reports a relationship with Blue Note Therapeutics that includes: consulting or advisory. Michael Antoni has patent #UMIP-483 licensed to University of Miami. Co-author is an author of books and treatment manuals on stress management for which he receives a small royalty - MA If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Interaction effects of optimism and sleep quality on cognitive impairment. High sleep quality scores indicate poorer sleep quality, and lower perceived cognitive impairment scores indicate greater impairment. High vs. Low was quantified as +/−1 SD from mean optimism. Optimism significantly buffered the effect of poor sleep quality on perceived cognitive impairments, such that among those low in optimism the poor sleep quality was significantly associated with greater perceived cognitive impairments, but the association was not significant among those high in optimism.
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References

    1. Artese A.L., Zhou X., Tometich D.B., Small B.J., Ahles T.A., Ahn J., Bethea T.N., Breen E.C., Cohen H.J., Extermann M., Graham D., Isaacs C., Jim H.S.L., McDonald B.C., Nakamura Z.M., Patel S.K., Rentscher K.E., Root J.C., Saykin A.J., Mandelblatt J. Physical activity and cognition: Longitudinal findings from the Thinking and Living with Cancer Study. Journal of the National Cancer Institute. 2024;116(12):2009–2021. doi: 10.1093/jnci/djae182. - DOI - PMC - PubMed
    1. Behrendt, S. (2023). lm.beta: Add standardized regression coefficients to linear-model-objects. In https://CRAN.R-project.org/package=lm.beta.
    1. Benitez-Buelga C., Sanchez-Barroso L., Gallardo M., Apellániz-Ruiz M., Inglada-Pérez L., Yanowski K., Carrillo J., Garcia-Estevez L., Calvo I., Perona R., Urioste M., Osorio A., Blasco M.A., Rodriguez-Antona C., Benitez J. Impact of chemotherapy on telomere length in sporadic and familial breast cancer patients. Breast Cancer Research and Treatment. 2015;149(2):385–394. doi: 10.1007/s10549-014-3246-6. - DOI - PMC - PubMed
    1. Besedovsky L., Lange T., Born J. Sleep and immune function. Pflugers Archiv : European Journal of Physiology. 2012;463(1):121–137. doi: 10.1007/s00424-011-1044-0. - DOI - PMC - PubMed
    1. Boscher C., Joly F., Clarisse B., Humbert X., Grellard J.M., Binarelli G., Tron L., Licaj I., Lange M. Perceived cognitive impairment in breast cancer survivors and its relationships with psychological factors. Cancers. 2020;(10):12. doi: 10.3390/cancers12103000. - DOI - PMC - PubMed

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