Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA.
J Gerontol A Biol Sci Med Sci. 2011 Dec;66(12):1343-9. doi: 10.1093/gerona/glr140. Epub 2011 Aug 22.
Research has found that patients treated for cancer generally have an increased risk for cognitive problems. However, many studies have focused on cognitive performance of cancer patients under the age of 65 who received chemotherapy treatment. Less studied is the extent to which cancer diagnosis may be associated with cognitive impairment as a late effect for older adults.
In this retrospective, co-twin design study, twin pairs 65 years of age and older discordant for cancer were identified from the Swedish Twin Registry. A pair was included if both twins participated in cognitive screening, and the twin with the cancer history was screened at least 3 years after cancer diagnosis and treatment.
Female, but not male, survivors of cancer were significantly (odds ratio = 2.42, 95% confidence interval = 1.23-4.74) more likely to exhibit cognitive impairment 3 or more years after cancer diagnosis and treatment as their co-twin without a history of cancer. In particular, risk was higher among survivors of gynecologic cancers (odds ratio = 10.00, 95% confidence interval = 1.28-78.11) and those who had treatments directly or potentially affecting ovarian functioning (odds ratio = 13.00, 95% confidence interval = 1.70-99.36) compared with their respective co-twins.
These findings suggest that localized treatments and other cancer-related factors should be explored as determinants that underlie the association between cancer diagnosis and long-term cognitive impairment.
研究发现，接受癌症治疗的患者通常存在认知问题的风险增加。然而，许多研究都集中在接受化疗治疗的 65 岁以下癌症患者的认知表现上。对于年龄较大的成年人，癌症诊断与认知障碍之间的关联作为晚期效应的程度研究较少。
在这项回顾性同卵双胞胎设计研究中，从瑞典双胞胎登记处确定了年龄在 65 岁及以上且癌症诊断不一致的双胞胎。如果双胞胎都参加了认知筛查，并且有癌症病史的双胞胎在癌症诊断和治疗后至少 3 年接受了筛查，则纳入一对双胞胎。
女性（比值比=2.42，95%置信区间=1.23-4.74），而不是男性癌症幸存者，在癌症诊断和治疗 3 年或更长时间后，表现出认知障碍的可能性显著更高，而其没有癌症病史的同卵双胞胎则没有。特别是，妇科癌症（比值比=10.00，95%置信区间=1.28-78.11）和那些接受过直接或潜在影响卵巢功能治疗的癌症幸存者（比值比=13.00，95%置信区间=1.70-99.36）与各自的同卵双胞胎相比，风险更高。
这些发现表明，局部治疗和其他癌症相关因素应作为癌症诊断与长期认知障碍之间关联的基础决定因素进行探讨。
