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在未经化疗的乳腺癌患者中,功能、心理社会、医疗和社会人口因素与认知筛查的关联。

Associations of functional, psychosocial, medical, and socio-demographic factors with cognitive screening in chemotherapy naïve patients with breast cancer.

机构信息

Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

出版信息

Psychooncology. 2019 Jan;28(1):167-173. doi: 10.1002/pon.4928. Epub 2018 Nov 8.

DOI:10.1002/pon.4928
PMID:30353629
Abstract

OBJECTIVE

To describe associations of functional, psychosocial, medical, and socio-demographic factors with performance on a cognitive screening test in chemotherapy naïve patients with breast cancer.

METHODS

Women with breast cancer were recruited between 2009 and 2018. The Blessed Orientation Memory Concentration Test (BOMC) was administered prior to chemotherapy. Associations between baseline BOMC and functional (Karnofsky Self-Reported Performance Rating Scale (KPS), Time Up and Go Test (TUG), Medical Outcomes Study (MOS) Physical Function, Instrumental Activities of Daily Living (IADL)), psychosocial (Mental Health Inventory-13, MOS Social Activity Limitation and Social Support Survey), medical, and socio-demographic variables were assessed using linear regression analysis.

RESULTS

In a sample of 331 women with breast cancer, the mean age was 65.2 years and 68.6% were 65 and older. Mean BOMC score was 3.60 on a scale from 0 (best) to 28 (worst). After controlling for demographic factors, worse BOMC screening test results were associated with KPS < 80 (P = 0.01), IADL<14 (P = 0.02), TUG ≥14 seconds (P = 0.001), worse MOS Physical Function (P = 0.0006), depressive symptoms (P = 0.04), and social activity limitations (P = 0.01).

CONCLUSION

In a sample of women with breast cancer, pre-treatment cognitive screening scores did not reveal profound cognitive impairment. BOMC screening scores were associated with multiple measures of physical function, but further research is needed to determine a clinically meaningful cut point in the BOMC for screening of cancer-related cognitive impairment.

摘要

目的

描述功能、心理社会、医学和社会人口统计学因素与未经化疗的乳腺癌患者认知筛查测试表现之间的关联。

方法

在 2009 年至 2018 年间招募了乳腺癌女性患者。在化疗前进行了Blessed 定向记忆浓度测试(BOMC)。使用线性回归分析评估了基线 BOMC 与功能(Karnofsky 自我报告表现评分量表(KPS)、时间向上和走测试(TUG)、医疗结果研究(MOS)身体功能、日常活动工具性活动(IADL))、心理社会(心理健康量表-13、MOS 社会活动限制和社会支持调查)、医学和社会人口统计学变量之间的关联。

结果

在 331 名患有乳腺癌的女性样本中,平均年龄为 65.2 岁,68.6%的人年龄在 65 岁及以上。BOMC 评分的平均得分为 0(最佳)至 28(最差)的 28 分制中的 3.60。在控制了人口统计学因素后,较差的 BOMC 筛查测试结果与 KPS<80(P=0.01)、IADL<14(P=0.02)、TUG≥14 秒(P=0.001)、MOS 身体功能较差(P=0.0006)、抑郁症状(P=0.04)和社会活动限制(P=0.01)相关。

结论

在乳腺癌女性样本中,治疗前认知筛查评分并未揭示出明显的认知障碍。BOMC 筛查评分与多项身体功能测量相关,但需要进一步研究来确定 BOMC 用于筛查癌症相关认知障碍的临床有意义的切点。

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