Cognitive Dysfunction in Older Breast Cancer Survivors PDF Download

Author: Adele Deborah Lenae Crouch
Publisher:
ISBN:
Category :
Languages : en
Pages : 234

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Book Description
Up to 75% of the more than 3.5 million breast cancer survivors (BCS) living in the United States report cognitive dysfunction. However, little is known about cognitive dysfunction among older BCS, who may be at greater risk. Therefore, the purpose of this dissertation was to characterize cognitive dysfunction in older BCS. Specific aims included: (1) synthesize the literature regarding cognitive dysfunction in older BCS; and (2) examine the relationships between a) objective cognitive function (immediate memory, delayed memory, attention, executive function-working memory, verbal fluency) and subjective cognitive function (attention); b) demographic factors, medical factors, treatment factors, and cancer-related symptoms (depressive symptoms, anxiety, fatigue, sleep disturbance) and cognitive function; and c) comorbidity and cognitive function and physical functioning, and quality of life (QoL) in older BCS. In an integrative review, to address aim 1, 12 studies were identified. Up to 41% of older BCS showed objective cognitive dysfunction on neuropsychological assessment, up to 64% reported subjective cognitive dysfunction concerns pre-treatment, and 50% incurred cognitive decline from pre- to post-treatment. Cognitive dysfunction was associated with older age, multiple comorbidities, chemotherapy, sleep disturbance, neuropsychological symptom cluster, frailty, and poorer QoL. To address aim 2, data were leveraged from a large, nationwide, QoL in younger versus older BCS study (PI: Champion), which included 335 older BCS who were e"0 years of age, had breast cancer (stage I-IIIa), received chemotherapy, and were 3-8 years post-diagnosis without recurrence. Findings included up to 19% of older BCS had mild-moderate objective cognitive dysfunction on at least one neuropsychological assessment, with 26% reporting poor-moderate subjective attention function. BCS, who were older, had less education and more depressive symptoms had greater cognitive dysfunction. Objective attention and executive function-working memory significantly and positively correlated with subjective attention. In turn, subjective cognitive dysfunction and increased number of comorbidities were related to poorer physical functioning. Subjective cognitive dysfunction was also related to poorer QoL. The findings from this study highlights the prevalence and complexity of cognitive dysfunction in older BCS. Further research is needed to better understand the intersection of aging, cancer, comorbidities and cognitive dysfunction and the negative implications in older BCS

Author: Adele Crouch
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Introduction: Breast cancer is the most common cancer in women. Aging is the greatest risk factor for the development of cancer. With improved screening and treatment, more women are surviving; however, breast cancer survivors (BCS) can be left facing disturbing symptoms including cognitive impairment (CI). Little research has been conducted in older BCS experiencing CI. Objectives: The objectives of this integrative review were to: (1) describe the incidence of CI in older BCS, (2) identify the cognitive domains impacted and measures used to assess CI, and (3) determine factors associated with CI in older BCS. Methods: Databases searched included PubMed, CINAHL, PsycINFO, and MEDLINE. This review focused on studies that examined CI in female BCS who were 65 years of age or older. Eligible studies were published in peeru2013reviewed journals, written in English, and measured CI subjectively or objectively. We excluded studies that included women with a dementia diagnosis. Results: Eight quantitative studies met inclusion criteria. Six used prospective designs and 2 were cross-sectional. Before treatment, incidence of CI ranged between 11%-41% using objective measures and ranged from 6%-64% when subjective measures were used. Four primary cognitive domains of impairment were identified, including memory, executive function, speed of processing, and language/verbal functioning. Factors associated with CI included older age, increased number of comorbidities, poorer physical functioning, frailty and poorer quality of life. Conclusions: CI is a common and significant problem in older BCS. Healthcare providers need to assess and address CI to promote quality of life in older BCS.

Author: Christina A. Meyers
Publisher: Cambridge University Press
ISBN: 9781107411814
Category : Medical
Languages : en
Pages : 0

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This book is a unique resource on the influence cancer and cancer treatments have on cognition. The majority of cancer patients on active treatment experience cognitive impairments often referred to as 'chemobrain' or 'chemofog'. In addition, patients with primary or metastatic tumors of the brain often experience direct neurologic symptoms. This book helps health care professionals working with cancer patients who experience cognitive changes and provides practical information to help improve care by reviewing and describing brain-behavior relationships; research-based evidence on cognitive changes that occur with various cancers and cancer treatments; assessment techniques, including neurocognitive assessment and neuroimaging techniques; and intervention strategies for affected patients. In short, it will explain how to identify, assess and treat these conditions.

Author: Gary Rodin
Publisher: Oxford University Press
ISBN: 0190236442
Category : Medical
Languages : en
Pages : 265

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Book Description
Managing Cancer and Living Meaningfully provides valuable insight into the experience of patients and families living with advanced cancer and describes a novel psychotherapeutic approach to help them live meaningfully, while also facing the threat of mortality. Managing Cancer and Living Meaningfully, also known by the acronym CALM, is a brief supportive-expressive intervention that can be delivered by a wide range of trained healthcare providers as part of cancer care or early palliative care. The authors provide an overview of the clinical experience and research that led to the development of CALM, a clear description of the intervention, and a manualized guide to aid in its delivery. Situated in the context of early palliative care, this text is destined to be become essential reading for healthcare professionals engaged in providing psychological support to patients and their families who face the practical and profound problems of advanced disease.

Author: Michael H. Antoni
Publisher: Oxford University Press
ISBN: 0190450029
Category : Psychology
Languages : en
Pages : 144

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Book Description
Living with HIV can be stressful, which can affect both your emotional and physical well-being. You may feel a loss of control over your life, socially isolated, or anxious and depressed. Studies have shown that prolonged stress can negatively impact the immune system, making it less effective in fighting illness. If you are concerned about the impact stress has on your life and on your health, this book can help you learn to relax and manage stress more effectively. This book presents a group treatment program that has been scientifically proven to reduce stress in individuals living with HIV. Written by the developers of this groundbreaking program, this workbook is based on the principles of Cognitive-Behavioral Stress Management (CBSM). You will learn a variety of relaxation techniques, all designed to help you reduce tension and stress. As you become more aware of stress and its effects, stress management skills will increase your ability to cope. This workbook comes complete with user-friendly monitoring forms and homework exercises designed to help reinforce the skills learned in group. It also includes instructions for relaxation practice that will remain useful long after you've completed the program. Used in conjunction with the group program described in the corresponding facilitator guide, this workbook will help you successfully manage stress and lead a more healthy life. TreatmentsThatWorkTM represents the gold standard of behavioral healthcare interventions! · All programs have been rigorously tested in clinical trials and are backed by years of research · A prestigious scientific advisory board, led by series Editor-In-Chief David H. Barlow, reviews and evaluates each intervention to ensure that it meets the highest standard of evidence so you can be confident that you are using the most effective treatment available to date · Our books are reliable and effective and make it easy for you to provide your clients with the best care available · Our corresponding workbooks contain psychoeducational information, forms and worksheets, and homework assignments to keep clients engaged and motivated · A companion website (www.oup.com/us/ttw) offers downloadable clinical tools and helpful resources · Continuing Education (CE) Credits are now available on select titles in collaboration with PsychoEducational Resources, Inc. (PER)

Author: Katherine R.P. George
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Purpose: Cancer-related cognitive impairment (CRCI) has been associated with fatigue, emotional distress, reduced quality of life, and caregiver strain. A potential treatment option for those with CRCI is cognitive rehabilitation, a behavioural approach to improve cognitive skills and quality of life. There have been some studies that involve caregivers in aspects of rehabilitation. There are no studies in the literature however, that include direct retraining of survivors on lost functions and concurrent participation by their caregivers across all sessions. To fill this gap, a comprehensive 10-week cognitive rehabilitation program (CRP) was created, with aims to generalize improvement to everyday life in survivors of breast cancer. Methods: A manualized CRP was developed and piloted with breast cancer survivors (BCSs) and their training partners. The program focused on psychoeducation and direct training on communication strategies, breathing/relaxation techniques, simple and complex attention, and higher-order thinking. Outcome measures included feasibility (retention and attendance rates), acceptability (homework compliance, session and program satisfaction), and measures of cognitive functioning and quality of life. BCSs and their individual partner underwent assessments at baseline, immediately after completing the program, and approximately 10 weeks later in order to investigate maintenance effects. Results: Six BCSs (ages 44-59; ≥1 year post-chemotherapy) and their training partners enrolled and completed this study with a (100% retention rate). Rates of attendance were high for both BCSs and their training partners (94% and 92.5% respectively) with all participants indicating high levels of satisfaction with the iv program. Repeated measures analyses of variance (ANOVAs) did not reveal a significant main effect for time on measures of sustained attention, processing speed, executive function, fluency (semantic and phonemic), verbal and visuospatial learning, recall and recognition. Repeated measures ANOVA revealed a significant main effect for time on measures of attentional capacity, focused attention, motor dexterity with the non-dominant hand, confrontation naming, and overall quality of life. Additionally, analyses using adjusted reliable change indices (RCI) were conducted on individual cases. RCIs yielded no change on most measures across time.

Author: Adele Crouch
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Background/Framework: For millions of cancer survivors, cognitive dysfunction is a prevalent, severe, and persistent problem that is associated with poorer quality of life. Unfortunately, the scientific basis for managing these cognitive changes in cancer survivors is extremely limited. Available evidence from pilot studies, including work by our own group, suggests that computerized cognitive training, which is based on the principles of neuroplasticity (ability of brain neurons to re-organize and form new neural networks), may be a viable treatment option. However, previous trials have been limited by their designs (failure to have attention control comparison), delivery (failure to offer in the home) and lack of inclusion of a response biomarker such as brain derived neurotrophic factor (BDNF), which we now know is associated with neural plasticity. Purpose: The purpose of this 2-group, double-blind, randomized controlled trial is to test the feasibility, satisfaction, and preliminary efficacy of a computerized home-based cognitive training program compared to attention control in breast cancer survivors (BCS) as well as to explore potential biomarkers of intervention effects. Methods: A total of 68 eligible BCS will be randomized to computerized cognitive training or attention control. A blinded and trained tester will perform data collection and neuropsychological testing at two time points: baseline prior to intervention (T1) and immediately after the 10-week cognitive training -program (+/- 7 days) (T2). Feasibility and satisfaction will be assessed through objective indicators (study adherence, completion rate) and self-report (facilitators, barriers, and perceived satisfaction) and cognitive performance will be assessed through objective neuropsychological tests. In addition, we will measure the effects of cognitive training on self-report measures of perceived cognitive function, associated symptoms (depressive symptoms, anxiety and fatigue), perceived work ability, and quality of life. Data will be analyzed using descriptive statistics and a general linear mixed model (GLMM). Simple main effects analyses will be used to follow up statistically significant interactions. Findings and Conclusions: Preliminary results of this trial will be presented, including an assessment of treatment fidelity measures used in this intervention trial. This work will represent the first rigorous trial of computerized cognitive training delivered in the home to BCS. Positive or negative study findings will provide empirical evidence for cliniciansu2019 recommendations and survivorsu2019 treatment selections for managing cognitive impairment in BCS. Acknowledgement: This work was funded by a grant from the Indiana University School of Nursing, Center for Enhancing Quality of Life (CEQL).

Author: Diane Von Ah
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Introduction: The diagnosis and treatment for breast cancer can disrupt quality of life. Many breast cancer survivors (BCS) also incur lingering symptoms, such as cognitive impairment, which has also been associated with diminished quality of life. However, the impact of cancer survivorship and cognitive impairment on quality of life is not well known. Objective: The purpose of this study was to examine whether cognitive impairment, breast cancer status (BCS versus healthy control [HC]), or both, are associated with quality of life, including psychological (depressive symptoms, overall well-being, post-traumatic stress and personal growth) and physical well-being (physical functioning and fatigue). Methods: 498 BCS who were 3 to 8 years post-chemotherapy treatment and 397 HC completed subjective memory and quality of life questionnaires and a one-time neuropsychological assessment, including tests of attention, memory, speed of processing, and verbal fluency. Cognitive impairment was defined as scoring 1.5 standard deviations below the mean of the control group on each test and overall composite. Separate linear regression models were used controlling for age, education, and income. Results: BCS reported significantly more memory loss than HC (p

Author: Diane Von Ah
Publisher:
ISBN:
Category :
Languages : en
Pages :

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Introduction: Breast cancer survivors (BCS) who represent approximately 3.2 million survivorsu2019 world-wide, often report ongoing symptoms, including perceived cognitive impairment. However, the long-term effects of perceived cognitive function on work-related outcomes in BCS is not well known. Objectives: The purpose of this study was to examine the relationship between perceived cognitive function including perceived cognitive impairment (PCI) and perceived cognitive ability (PCA) and work ability, work performance, work productivity, and intent to leave employment BCS. Methods: Employed BCS completed one-time questionnaires assessing PCI and PCA and work-related outcomes including, work ability, work performance, work productivity and intent to turnover. Descriptive statistics and separate regression models were used to analyze the data. Results: Participants were 68 employed female BCS who were on average 52 (SD=8.6) years old and 5 (SD=3.8) years post-treatment with majority working full time. PCI was associated with poorer work ability (B=-0.658), work performance (time-B=0.647; physical-B=-0.414, and mental-B=0.689) and work productivity (B=0.731), but not intent to leave work. PCA was related to higher levels of work ability (B=0.472), work performance (time-B=-0.462 and mental-B=-0.453) and work productivity (u03b2=-0.494), but not physical demands or intent to turnover. Conclusions: Employed BCS with negative perceptions of cognitive function reported poorer work outcomes with the exception of the intent to leave employment. In contrast, positive views of oneu2019s cognitive abilities were related to improved ratings of work outcomes again with the exception of intent to leave employment. Healthcare providers need to assess and address perceived cognitive functioning.to promote work-related outcomes in BCS.

Author: Robert Ferguson
Publisher: Oxford University Press
ISBN: 0197521592
Category : Medical
Languages : en
Pages : 176

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Book Description
Cancer-related cognitive impairment (CRCI) may affect nearly half of all cancer survivors and can persist for years after completing cancer treatment. Memory and Attention Adaptation Training (MAAT) is a cognitive-behavioral therapy offering evidence-based, nonpharmacological treatment of this common survivorship condition. Organized into a session-by-session Clinician Manual and related Survivor Workbook, MAAT is conducted in eight treatment visits and has been demonstrated effective when delivered through telehealth technology, so survivors can readily fit MAAT into their busy lives. The MAAT Clinician Manual provides a clearly written summary of the scientific literature on CRCI and detailed guidance for each visit, including an agenda outline, in-depth discussion, and accompanying fidelity checklist in the appendix. Designed to be used in conjunction with the Survivor Workbook, the Clinician Manual also includes the full text of the workbook in a separate appendix, giving clinicians convenient one-volume access to the complete material.