Factors Associated with Cognitive Function in Breast Cancer Patients Complaining Cognitive Decline / 정신신체의학

ABSTRACT

OBJECTIVES: Cognitive complaints are reported frequently after breast cancer treatments. The causes of cognitive decline are multifactorial, a result of the effect of cancer itself, chemotherapy, and psychological factors such as depression and anxiety. However, cognitive decline does not always correlate with neuropsychological test performance. The purpose of this study was to examine the relationship of subjective cognitive decline with objective measurement and to explore associated factors of cognitive function in breast cancer survivors. METHODS: We included 29 breast cancer survivors who complain cognitive decline at least 6 months after treatment and 20 age-matched healthy controls. Neuropsychological tests were performed in all participants. Multivariable regression analysis evaluated associations between neuropsychological test scores and psychological distress including depression and anxiety, also considering age, education, and comorbidity. RESULTS: There were no statistically significant differences in neuropsychological test performances. However, the breast cancer survivors showed a significantly higher depression(p=0.002) and anxiety(p < 0.001) than the healthy controls did. Among the cancer survivors, poorer executive function was strongly associated with higher depression(β=−0.336, p=0.001) and anxiety(β=−0.273, p=0.009), after controlling for age, education, and comorbidity. In addition, poorer attention was also significantly related with depression(β=−0.375, p=0.023) and anxiety (β=−0.404, p=0.013). CONCLUSIONS: The results of this study showed the discrepancies between subjective complaints and objective measures of cognitive function in breast cancer survivors. It suggests that subjective cognitive decline could be indicators of psychological distress such as depression and anxiety.