Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA.
Ann Behav Med. 2023 Apr 5;57(3):237-248. doi: 10.1093/abm/kaac048.
Older cancer survivors are at risk for cognitive decline. Physical activity can improve cognition, and better cognitive function may facilitate greater physical activity.
We examined the potential bidirectional relationship between cognitive function and physical activity in older breast cancer survivors and controls.
The sample included women with newly diagnosed, nonmetastatic breast cancer (n = 395) and women without cancer (n = 374) ages 60-98. Participants were recruited as part of a larger multisite study, assessed prior to systemic therapy, and followed yearly for 36 months. Attention, processing speed, and executive function was measured using six neuropsychological tests, self-reported cognitive function using the Perceived Cognitive Impairments subscale of the Functional Assessment of Cancer Therapy-Cognitive Function , and physical activity using the International Physical Activity Questionnaire-Short Form. Separate random intercepts cross-lagged panel models were used to examine the between- and within-person effects for survivors and controls, controlling for age, education, and study site.
Survivors reported significantly less physical activity than controls at baseline (1,284.92 vs. 2,085.98 MET min/week, p < .05). When survivors reported higher activity, they simultaneously had better objective cognition at 12 months (β = 0.24, p = .04) and reported better perceived cognition at 12 and 24 months (β = 0.25, p = .03), but this relationship was not seen in controls. Cognition did not predict subsequent physical activity or vice versa in either group.
Cognition and physical activity are cross-sectionally associated in survivors, but the expected prospective relationships were not found.
老年癌症幸存者存在认知能力下降的风险。身体活动可以改善认知功能，而更好的认知功能可能促进更多的身体活动。
我们研究了老年乳腺癌幸存者和对照组中认知功能与身体活动之间的潜在双向关系。
该样本包括 395 名新诊断的非转移性乳腺癌患者和 374 名无癌症患者，年龄在 60-98 岁之间。参与者作为更大的多地点研究的一部分招募，在系统治疗前进行评估，并在 36 个月内每年随访一次。使用六项神经心理学测试测量注意力、处理速度和执行功能，使用癌症治疗认知功能功能评估 - 认知功能的感知认知障碍子量表自我报告认知功能，使用国际体力活动问卷 - 短表测量身体活动。使用单独的随机截距交叉滞后面板模型来检查幸存者和对照组的个体间和个体内效应，同时控制年龄、教育和研究地点。
幸存者在基线时报告的身体活动量明显少于对照组（1,284.92 对 2,085.98 MET min/周，p <.05）。当幸存者报告更高的活动量时，他们在 12 个月时同时具有更好的客观认知（β=0.24，p=0.04），并在 12 和 24 个月时报告更好的感知认知（β=0.25，p=0.03），但在对照组中没有发现这种关系。在两组中，认知都没有预测随后的身体活动，反之亦然。
认知和身体活动在幸存者中存在横断面关联，但没有发现预期的前瞻性关系。
