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Erschienen in: International Journal of Behavioral Medicine 1/2024

31.01.2023 | Full length manuscript

Perceived Executive Functioning Deficits After Diagnosis in Women with Non-Metastatic Breast Cancer Prior to Adjuvant Therapies

verfasst von: Sheila N. Garland, Joshua Tulk, Nicole Rodriguez, Joshua A. Rash, Jonathan M. Fawcett, Joy McCarthy, Melanie Seal, Kara Laing

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 1/2024

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Abstract

Background

Perceived deficits in executive functioning are among the many difficulties that women diagnosed with breast cancer experience. This study assessed the presence of perceived deficits in executive functioning among women with breast cancer prior to systemic treatment and radiation and associations between perceived deficits in executive function and comorbid fatigue, sleep, and mood disturbance.

Method

Participants were recruited following their breast cancer diagnosis and assessed using the Behavior Rating Inventory of Executive Function for Adults (BRIEF-A), subjective and objective measures of sleep duration and efficiency, and self-report measures of insomnia severity, sleep quality, fatigue, and mood disturbance. Hierarchical regression was used to examine associations between symptoms, adjusting for age and education.

Results

The final sample included 92 women with a mean age of 60.7 years and 13.5 years of education. Thirteen percent of participants reported global executive dysfunction. After partitioning out variability from other independent variables, fatigue (p = < .001), perceived sleep quality (p = .030), and symptoms of insomnia (p = .008) accounted for 13.3%, 5.7%, and 8.5% of unique variance in perceived executive functioning, respectively. Emotional fatigue was most strongly associated with perceived deficits in executive functioning. Neither subjective or objective sleep duration or efficiency was associated with perceived deficits in executive functioning.

Conclusion

Fatigue, particularly emotional fatigue, insomnia, and poor sleep quality had the strongest associations with perceived deficits in executive functioning. Sleep interventions and fatigue management strategies may prove useful for women who seek to improve their perceived executive functioning.
Literatur
1.
Zurück zum Zitat Brenner DR, et al. Projected estimates of cancer in Canada in 2020. CMAJ. 2020;192:E199–205. Brenner DR, et al. Projected estimates of cancer in Canada in 2020. CMAJ. 2020;192:E199–205.
2.
Zurück zum Zitat Pendergrass JC, Targum SD, Harrison JE. Cognitive impairment associated with cancer: A brief review. Innov Clin Neurosci. 2018;15(1–2):36–44.PubMedPubMedCentral Pendergrass JC, Targum SD, Harrison JE. Cognitive impairment associated with cancer: A brief review. Innov Clin Neurosci. 2018;15(1–2):36–44.PubMedPubMedCentral
3.
Zurück zum Zitat Lange M, Joly F. How to identify and manage cognitive dysfunction after breast cancer treatment. J Oncol Pract. 2017;13(12):784–90.CrossRefPubMed Lange M, Joly F. How to identify and manage cognitive dysfunction after breast cancer treatment. J Oncol Pract. 2017;13(12):784–90.CrossRefPubMed
4.
Zurück zum Zitat Myers JS. Cancer- and chemotherapy-related cognitive changes: the patient experience. Semin Oncol Nurs. 2013;29(4):300–7.CrossRefPubMed Myers JS. Cancer- and chemotherapy-related cognitive changes: the patient experience. Semin Oncol Nurs. 2013;29(4):300–7.CrossRefPubMed
5.
Zurück zum Zitat Boykoff N, Moieni M, Subramanian SK. Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Survivor Res Pract. 2009;3(4):223–32.CrossRefPubMed Boykoff N, Moieni M, Subramanian SK. Confronting chemobrain: an in-depth look at survivors’ reports of impact on work, social networks, and health care response. J Cancer Survivor Res Pract. 2009;3(4):223–32.CrossRefPubMed
6.
Zurück zum Zitat Joly F, et al. Impact of cancer and its treatments on cognitive function: advances in research from the Paris international cognition and cancer task force symposium and update since 2012. J Pain Symptom Manage. 2015;50(6):830–41.CrossRefPubMed Joly F, et al. Impact of cancer and its treatments on cognitive function: advances in research from the Paris international cognition and cancer task force symposium and update since 2012. J Pain Symptom Manage. 2015;50(6):830–41.CrossRefPubMed
7.
Zurück zum Zitat Janelsins MC, et al. Prevalence, mechanisms, and management of cancer-related cognitive impairment. Int Rev Psychiatr (Abingdon, England). 2014;26(1):102–13.CrossRefPubMedPubMedCentral Janelsins MC, et al. Prevalence, mechanisms, and management of cancer-related cognitive impairment. Int Rev Psychiatr (Abingdon, England). 2014;26(1):102–13.CrossRefPubMedPubMedCentral
8.
Zurück zum Zitat Jansen CE, et al. A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients. Support Care Cancer. 2011;19(10):1647–56.CrossRefPubMed Jansen CE, et al. A prospective longitudinal study of chemotherapy-induced cognitive changes in breast cancer patients. Support Care Cancer. 2011;19(10):1647–56.CrossRefPubMed
9.
Zurück zum Zitat Wang L, et al. Executive function alternations of breast cancer patients after chemotherapy: Evidence from resting-state functional MRI. Acad Radiol. 2016;23(10):1264–70.CrossRefPubMed Wang L, et al. Executive function alternations of breast cancer patients after chemotherapy: Evidence from resting-state functional MRI. Acad Radiol. 2016;23(10):1264–70.CrossRefPubMed
10.
Zurück zum Zitat Tao L., et al. Impairment of the executive function in breast cancer patients receiving chemotherapy treatment: a functional MRI study. Eur J Cancer Care (Engl). 2017;26(6). Tao L., et al. Impairment of the executive function in breast cancer patients receiving chemotherapy treatment: a functional MRI study. Eur J Cancer Care (Engl). 2017;26(6).
11.
Zurück zum Zitat Van Dyk K, et al. Associating persistent self-reported cognitive decline with neurocognitive decline in older breast cancer survivors using machine learning: The Thinking and Living with Cancer study. J Geriatr Oncol. 2022. Van Dyk K, et al. Associating persistent self-reported cognitive decline with neurocognitive decline in older breast cancer survivors using machine learning: The Thinking and Living with Cancer study. J Geriatr Oncol. 2022.
12.
Zurück zum Zitat Hutchinson AD, et al. Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review. Cancer Treat Rev. 2012;38(7):926–34.CrossRefPubMed Hutchinson AD, et al. Objective and subjective cognitive impairment following chemotherapy for cancer: a systematic review. Cancer Treat Rev. 2012;38(7):926–34.CrossRefPubMed
13.
Zurück zum Zitat Braun SE, et al. Subjective executive dysfunction in patients with primary brain tumors and their informants: relationships with neurocognitive, psychological, and daily functioning. Brain Inj. 2021;35(14):1665–73.CrossRefPubMedPubMedCentral Braun SE, et al. Subjective executive dysfunction in patients with primary brain tumors and their informants: relationships with neurocognitive, psychological, and daily functioning. Brain Inj. 2021;35(14):1665–73.CrossRefPubMedPubMedCentral
14.
Zurück zum Zitat Loughan AR, Braun SE, Lanoye A. Executive dysfunction in neuro-oncology: Behavior Rating Inventory of Executive Function in adult primary brain tumor patients. Appl Neuropsychol Adult. 2020;27(5):393–402.CrossRefPubMed Loughan AR, Braun SE, Lanoye A. Executive dysfunction in neuro-oncology: Behavior Rating Inventory of Executive Function in adult primary brain tumor patients. Appl Neuropsychol Adult. 2020;27(5):393–402.CrossRefPubMed
15.
Zurück zum Zitat Savard J, Morin CM. Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol Official J Am Soc Clin Oncol. 2001;19(3):895–908.CrossRefPubMed Savard J, Morin CM. Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol Official J Am Soc Clin Oncol. 2001;19(3):895–908.CrossRefPubMed
16.
17.
Zurück zum Zitat Garland SN, Ivers H, Savard J. Prospective rates, longitudinal associations, and factors associated with comorbid insomnia symptoms and perceived cognitive impairment. Front Neurosci. 2022;15: 817933.CrossRefPubMedPubMedCentral Garland SN, Ivers H, Savard J. Prospective rates, longitudinal associations, and factors associated with comorbid insomnia symptoms and perceived cognitive impairment. Front Neurosci. 2022;15: 817933.CrossRefPubMedPubMedCentral
18.
Zurück zum Zitat Berger AM, et al. Cancer-related fatigue, version 2.2015: Clinical practice guidelines in oncology. J Natl Comprehensive Cancer Netw. 2015;13(8):1012–1039. Berger AM, et al. Cancer-related fatigue, version 2.2015: Clinical practice guidelines in oncology. J Natl Comprehensive Cancer Netw. 2015;13(8):1012–1039.
19.
Zurück zum Zitat Zachariae R, et al. Internet-delivered cognitive-behavioral therapy for insomnia in breast cancer survivors: a randomized controlled trial. J Natl Cancer Inst. 2018;110(8):880–7.CrossRefPubMedPubMedCentral Zachariae R, et al. Internet-delivered cognitive-behavioral therapy for insomnia in breast cancer survivors: a randomized controlled trial. J Natl Cancer Inst. 2018;110(8):880–7.CrossRefPubMedPubMedCentral
20.
Zurück zum Zitat Goedendorp MM, et al. Development of fatigue in cancer survivors: a prospective follow-up study from diagnosis into the year after treatment. J Pain Symptom Manage. 2013;45(2):213–22.CrossRefPubMed Goedendorp MM, et al. Development of fatigue in cancer survivors: a prospective follow-up study from diagnosis into the year after treatment. J Pain Symptom Manage. 2013;45(2):213–22.CrossRefPubMed
21.
Zurück zum Zitat Pertl MM, et al. Predictors of fatigue in cancer patients before and after chemotherapy. J Health Psychol. 2014;19(6):699–710.CrossRefPubMed Pertl MM, et al. Predictors of fatigue in cancer patients before and after chemotherapy. J Health Psychol. 2014;19(6):699–710.CrossRefPubMed
22.
Zurück zum Zitat Minton O, Stone PC. A comparison of cognitive function, sleep and activity levels in disease-free breast cancer patients with or without cancer-related fatigue syndrome. BMJ Support Palliat Care. 2012;2(3):231–8.CrossRefPubMedPubMedCentral Minton O, Stone PC. A comparison of cognitive function, sleep and activity levels in disease-free breast cancer patients with or without cancer-related fatigue syndrome. BMJ Support Palliat Care. 2012;2(3):231–8.CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Xu S, et al. Cognition, quality-of-life, and symptom clusters in breast cancer: Using Bayesian networks to elucidate complex relationships. Psychooncology. 2018;27(3):802–9.CrossRefPubMed Xu S, et al. Cognition, quality-of-life, and symptom clusters in breast cancer: Using Bayesian networks to elucidate complex relationships. Psychooncology. 2018;27(3):802–9.CrossRefPubMed
24.
Zurück zum Zitat Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–98.
25.
Zurück zum Zitat Rabin LA, et al. Self- and informant reports of executive function on the BRIEF-A in MCI and older adults with cognitive complaints. Arch Clin Neuropsychol Official J Natl Acad Neuropsychol. 2006;21(7):721–32.CrossRefPubMed Rabin LA, et al. Self- and informant reports of executive function on the BRIEF-A in MCI and older adults with cognitive complaints. Arch Clin Neuropsychol Official J Natl Acad Neuropsychol. 2006;21(7):721–32.CrossRefPubMed
26.
Zurück zum Zitat Bastien CH, et al. Validation of the Insomnia Severity Index as an Outcome Measure for Insomnia Research. Sleep Med. 2001;2(4):297–307. Bastien CH, et al. Validation of the Insomnia Severity Index as an Outcome Measure for Insomnia Research. Sleep Med. 2001;2(4):297–307.
27.
Zurück zum Zitat Buysse DJ, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193.CrossRefPubMed Buysse DJ, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989;28(2):193.CrossRefPubMed
29.
Zurück zum Zitat Rupp TL, Balkin TJ. Comparison of motionlogger watch and actiwatch actigraphs to polysomnography for sleep/wake estimation in healthy young adults. Behav Res Methods. 2011;43(4):1152–60.CrossRefPubMed Rupp TL, Balkin TJ. Comparison of motionlogger watch and actiwatch actigraphs to polysomnography for sleep/wake estimation in healthy young adults. Behav Res Methods. 2011;43(4):1152–60.CrossRefPubMed
30.
Zurück zum Zitat Cole RJ, et al. Automatic sleep/wake identification from wrist activity. Sleep. 1992;15(5):461–9.CrossRefPubMed Cole RJ, et al. Automatic sleep/wake identification from wrist activity. Sleep. 1992;15(5):461–9.CrossRefPubMed
31.
Zurück zum Zitat Mitchell AJ, Meader N, Symonds P. Diagnostic validity of the hospital anxiety and depression scale (HADS) in cancer and palliative settings: a meta-analysis. J Affect Disord. 2010;126(3):335–48.CrossRefPubMed Mitchell AJ, Meader N, Symonds P. Diagnostic validity of the hospital anxiety and depression scale (HADS) in cancer and palliative settings: a meta-analysis. J Affect Disord. 2010;126(3):335–48.CrossRefPubMed
32.
33.
Zurück zum Zitat Tabachnick B, Fidell L. Using Multivariate Statistics. Boston: Pearson; 2012. Tabachnick B, Fidell L. Using Multivariate Statistics. Boston: Pearson; 2012.
34.
Zurück zum Zitat Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2015;15:77.CrossRefPubMedPubMedCentral Meneses-Echávez JF, González-Jiménez E, Ramírez-Vélez R. Effects of supervised exercise on cancer-related fatigue in breast cancer survivors: a systematic review and meta-analysis. BMC Cancer. 2015;15:77.CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Ferguson CJ. An effect size primer: A guide for clinicians and researchers. Prof Psychol Res Pract. 2009;40(5):532–8.CrossRef Ferguson CJ. An effect size primer: A guide for clinicians and researchers. Prof Psychol Res Pract. 2009;40(5):532–8.CrossRef
36.
Zurück zum Zitat Rodriguez N, et al. Factors associated with cognitive impairment during the first year of treatment for nonmetastatic breast cancer. Cancer Med. 2021;10(4):1191–1200. Rodriguez N, et al. Factors associated with cognitive impairment during the first year of treatment for nonmetastatic breast cancer. Cancer Med. 2021;10(4):1191–1200.
37.
Zurück zum Zitat Kobayashi LC, et al. Cognitive function prior to systemic therapy and subsequent well-being in older breast cancer survivors: Longitudinal findings from the thinking and living with cancer study. Psychooncology. 2020;29(6):1051–9.CrossRefPubMedPubMedCentral Kobayashi LC, et al. Cognitive function prior to systemic therapy and subsequent well-being in older breast cancer survivors: Longitudinal findings from the thinking and living with cancer study. Psychooncology. 2020;29(6):1051–9.CrossRefPubMedPubMedCentral
38.
Zurück zum Zitat Root JC, et al. Association of markers of tumor aggressivity and cognition in women with breast cancer before adjuvant treatment: The thinking and living with cancer study. Breast Cancer Res Treat. 2022;194(2):413–22.CrossRefPubMedPubMedCentral Root JC, et al. Association of markers of tumor aggressivity and cognition in women with breast cancer before adjuvant treatment: The thinking and living with cancer study. Breast Cancer Res Treat. 2022;194(2):413–22.CrossRefPubMedPubMedCentral
39.
Zurück zum Zitat Wu LM, et al. Cross-sectional study of patient-reported neurobehavioral problems following hematopoietic stem cell transplant and health-related quality of life. Psychooncology. 2014;23(12):1406–14.CrossRefPubMed Wu LM, et al. Cross-sectional study of patient-reported neurobehavioral problems following hematopoietic stem cell transplant and health-related quality of life. Psychooncology. 2014;23(12):1406–14.CrossRefPubMed
40.
Zurück zum Zitat Lovstad M, et al. Behavior rating inventory of executive function adult version in patients with neurological and neuropsychiatric conditions: symptom levels and relationship to emotional distress. J Int Neuropsychol Soc. 2016;22(6):682–94.CrossRefPubMed Lovstad M, et al. Behavior rating inventory of executive function adult version in patients with neurological and neuropsychiatric conditions: symptom levels and relationship to emotional distress. J Int Neuropsychol Soc. 2016;22(6):682–94.CrossRefPubMed
41.
Zurück zum Zitat Koyama N, et al. Investigation of optimal time for starting betamethasone using fatigue scores and prognostic nutritional index in terminally ill patients with cancer-related fatigue. Am J Hosp Palliat Care. 2017;34(5):449–55.CrossRefPubMed Koyama N, et al. Investigation of optimal time for starting betamethasone using fatigue scores and prognostic nutritional index in terminally ill patients with cancer-related fatigue. Am J Hosp Palliat Care. 2017;34(5):449–55.CrossRefPubMed
42.
Zurück zum Zitat Hofman M, et al. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12(Suppl 1):4–10.CrossRefPubMed Hofman M, et al. Cancer-related fatigue: the scale of the problem. Oncologist. 2007;12(Suppl 1):4–10.CrossRefPubMed
43.
Zurück zum Zitat de Lima FD, et al. Cancer-related fatigue and muscle quality in hodgkin’s lymphoma survivors. Integrative Cancer Ther. 2017:1534735417712009. de Lima FD, et al. Cancer-related fatigue and muscle quality in hodgkin’s lymphoma survivors. Integrative Cancer Ther. 2017:1534735417712009.
44.
Zurück zum Zitat Wang XS, Woodruff JF. Cancer-related and treatment-related fatigue. Gynecol Oncol. 2015;136(3):446.CrossRefPubMed Wang XS, Woodruff JF. Cancer-related and treatment-related fatigue. Gynecol Oncol. 2015;136(3):446.CrossRefPubMed
45.
Zurück zum Zitat Gullett JM, et al. Relationship of fatigue with cognitive performance in women with early-stage breast cancer over 2 years. Psychooncology. 2019;28(5):997–1003.CrossRefPubMedPubMedCentral Gullett JM, et al. Relationship of fatigue with cognitive performance in women with early-stage breast cancer over 2 years. Psychooncology. 2019;28(5):997–1003.CrossRefPubMedPubMedCentral
46.
Zurück zum Zitat Li J, et al. Perceived cognitive impairment in Chinese patients with breast cancer and its relationship with post-traumatic stress disorder symptoms and fatigue. Psychooncology. 2015;24(6):676–82.CrossRefPubMed Li J, et al. Perceived cognitive impairment in Chinese patients with breast cancer and its relationship with post-traumatic stress disorder symptoms and fatigue. Psychooncology. 2015;24(6):676–82.CrossRefPubMed
47.
Zurück zum Zitat Liou KT, et al. The relationship between insomnia and cognitive impairment in breast cancer survivors. JNCI Cancer Spectr. 2019;3(3):pkz041. Liou KT, et al. The relationship between insomnia and cognitive impairment in breast cancer survivors. JNCI Cancer Spectr. 2019;3(3):pkz041.
48.
Metadaten
Titel
Perceived Executive Functioning Deficits After Diagnosis in Women with Non-Metastatic Breast Cancer Prior to Adjuvant Therapies
verfasst von
Sheila N. Garland
Joshua Tulk
Nicole Rodriguez
Joshua A. Rash
Jonathan M. Fawcett
Joy McCarthy
Melanie Seal
Kara Laing
Publikationsdatum
31.01.2023
Verlag
Springer US
Erschienen in
International Journal of Behavioral Medicine / Ausgabe 1/2024
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-023-10153-6

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