Hartman Sheri J, Nelson Sandahl H, Myers Emily, Natarajan Loki, Sears Dorothy D, Palmer Barton W, Weiner Lauren S, Parker Barbara A, Patterson Ruth E
Department of Family Medicine and Public Health, University of California-San Diego, La Jolla, California.
University of California-San Diego Moores Cancer Center, University of California-San Diego, La Jolla, California.
Cancer. 2018 Jan 1;124(1):192-202. doi: 10.1002/cncr.30987. Epub 2017 Sep 19.
Increasing physical activity can improve cognition in healthy and cognitively impaired adults; however, the benefits for cancer survivors are unknown. The current study examined a 12-week physical activity intervention, compared with a control condition, on objective and self-reported cognition among breast cancer survivors.
Sedentary breast cancer survivors were randomized to an exercise arm (n = 43) or a control arm (n = 44). At baseline and at 12 weeks, objective cognition was measured with the National Institutes of Health Cognitive Toolbox, and self-reported cognition using the Patient-Reported Outcomes Measurement Information System scales. Linear mixed-effects regression models tested intervention effects for changes in cognition scores.
On average, participants (n = 87) were aged 57 years (standard deviation, 10.4 years) and were 2.5 years (standard deviation, 1.3 years) post surgery. Scores on the Oral Symbol Digit subscale (a measure of processing speed) evidenced differential improvement in the exercise arm versus the control arm (b = 2.01; P < .05). The between-group differences in improvement on self-reported cognition were not statistically significant but were suggestive of potential group differences. Time since surgery moderated the correlation, and participants who were ≤2 years post surgery had a significantly greater improvement in Oral Symbol Digit score (exercise vs control (b = 4.00; P < .01), but no significant improvement was observed in patients who were >2 years postsurgery (b = -1.19; P = .40). A significant dose response was observed with greater increased physical activity associated with objective and self-reported cognition in the exercise arm.
The exercise intervention significantly improved processing speed, but only among those who had been diagnosed with breast cancer within the past 2 years. Slowed processing speed can have substantial implications for independent functioning, supporting the potential importance of early implementation of an exercise intervention among patients with breast cancer. Cancer 2018;124:192-202. © 2017 American Cancer Society.
增加身体活动可改善健康及认知受损成年人的认知能力;然而,对癌症幸存者的益处尚不清楚。本研究探讨了一项为期12周的身体活动干预对乳腺癌幸存者客观及自我报告认知的影响,并与对照情况进行比较。
久坐不动的乳腺癌幸存者被随机分为运动组(n = 43)或对照组(n = 44)。在基线和12周时,使用美国国立卫生研究院认知工具箱测量客观认知,使用患者报告结局测量信息系统量表测量自我报告认知。线性混合效应回归模型检验了认知分数变化的干预效果。
参与者(n = 87)平均年龄为57岁(标准差10.4岁),术后2.5年(标准差1.3年)。口语符号数字子量表(处理速度的一项测量指标)得分显示,运动组与对照组有不同程度的改善(b = 2.01;P <.05)。自我报告认知改善的组间差异无统计学意义,但提示可能存在组间差异。手术时间对相关性有调节作用,术后≤2年的参与者口语符号数字得分改善显著更大(运动组与对照组相比,b = 4.00;P <.01),但术后>2年的患者未观察到显著改善(b = -1.19;P =.40)。在运动组中,观察到身体活动增加量越大与客观及自我报告认知之间存在显著的剂量反应关系。
运动干预显著提高了处理速度,但仅在过去2年内被诊断为乳腺癌的患者中有效。处理速度减慢对独立功能有重大影响,这支持了对乳腺癌患者早期实施运动干预的潜在重要性。《癌症》2018年;124:192 - 202。©2017美国癌症协会