ABSTRACT
Objective: This narrative review aims to (1) identify neuropsychological tests for assessing cognitive function impairment in patients with cancer, specifically in the domains of attention and memory, (2) summarize the characteristics of these tests, including cognitive function domains, test content, readability, and psychometric quality, and (3) evaluate the feasibility of each test in cancer care. Methods: Data sources include published test manuals, documents from official web pages, and published journal articles. Results: Our study identified eight neuropsychological tests that are most frequently used to assess the attention and memory domains of objective cognitive function in patients with breast cancer. These tests include the California Verbal Learning Test, Hopkins Verbal Learning Test, Rey Auditory Verbal Learning Test, Rey-Osterrieth Complex Figure, CNS Vital Signs, Wechsler Adult Intelligence Scale, Wechsler Memory Scale, and Trail Making Test. They demonstrate acceptable evidence of psychometric quality and varying degrees of feasibility. Test feasibility is influenced by factors such as short testing time, brevity and comprehensiveness, clear cognitive domain distinctions, availability of normative data, minimal practice effects, ease of administration, and limited attention-span requirements. These attributes determine a test's feasibility for use in cancer care. Among the evaluated measures, the California Verbal Learning Test for memory, the Trail Making Test for attention, and the CNS Vital Signs for comprehensive assessment emerge as the most practical choices for cancer care. Conclusions: The assessment and management of cognitive function impairment are crucial for enhancing the quality of life in cancer survivors. Nurses should possess knowledge of assessment tools for early detection and the ongoing monitoring of this symptom's progression.
ABSTRACT
BACKGROUND: Findings from longitudinal studies can provide more conclusive evidence as to the impact of chemotherapy on cognitive functioning. OBJECTIVES: This study aimed to ( a ) synthesize the evidence from longitudinal studies of the neuropsychological effects associated with chemotherapy in breast cancer patients, ( b ) identify associated factors, and ( c ) evaluate methodological issues. METHODS: Data were extracted from PubMed, EMBASE, CINAHL, PsycINFO, and the Cochrane Library. Inclusion criteria included the original study with the breast cancer sample, validated measure, and at least 1 baseline data point before and after chemotherapy began. Data accrued for sample characteristics, data-collection time points, statistical methods for longitudinal data analysis, outcome measures, and major findings (eg, longitudinal changes in cognitive function). RESULTS: We selected 42 articles for this review. The sample sizes ranged from 20 to 610, and most recruited were younger than 70 years. We found a trend across studies-statistically significant objective cognitive function deteriorations in severity and prevalence after initiating chemotherapy compared with a control group or relative to their baseline observations. A subsample, as high as 65%, experienced marked declines in cognitive function after initiating chemotherapy. The memory domain was most affected. The consistently associated factors were education, IQ, and regimen. Major methodological concerns were the measurement-the wide range of neuropsychological tests and a test's unclear domains. CONCLUSION: Chemotherapy affects objective cognitive function in some subsets. The highest-impact time point, mechanisms, and clinical significance of chemotherapy-associated cognitive impairment need additional evidence. IMPLICATION FOR PRACTICE: Clinicians must assess and manage cognitive impairment during and after chemotherapy.
