癌症患者中年和老年人的神经认知测试表现：西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）和 SOL-神经认知老化辅助研究。
Neurocognitive test performance following cancer among middle-aged and older adults in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and the SOL-Investigation of Neurocognitive Aging Ancillary Study.
机构信息
Division of Epidemiology and Biostatistics, School of Public Health, San Diego State University, San Diego, California, USA.
UC San Diego Health Moores Cancer Center, La Jolla, California, USA.
出版信息
Cancer Med. 2023 May;12(10):11860-11870. doi: 10.1002/cam4.5863. Epub 2023 Mar 31.
BACKGROUND
Cancer patients and survivors often experience acute cognitive impairments; however, the long-term cognitive impact remains unclear particularly among Hispanics/Latinos. We examined the association between cancer history and neurocognitive test performance among middle-aged and older Hispanic/Latinos.
METHODS
Participants included 9639 Hispanic/Latino adults from the community-based and prospective Hispanic Community Health Study/Study of Latinos. At baseline (2008-2011; V1), participants self-reported their cancer history. At V1 and again at a 7-year follow-up (2015-2018; V2), trained technicians administered neurocognitive tests including the Brief-Spanish English Verbal Learning Test (B-SEVLT), Word Fluency Test (WF), and Digit Symbol Substitution Test (DSS). We used survey linear regression to estimate the overall, sex-specific, and cancer site-specific [i.e., cervix, breast, uterus, and prostate] adjusted associations between cancer history and neurocognitive test performance at V1 and changes from V1 to V2.
RESULTS
At V1, a history of cancer (6.4%) versus no history of cancer (93.6%) was associated with higher WF scores (β = 0.14, SE = 0.06; p = 0.03) and global cognition (β = 0.09, SE = 0.04; p = 0.04). Among women, a history of cervical cancer predicted decreases in SEVLT-Recall scores (β = -0.31, SE = 0.13; p = 0.02) from V1 to V2, and among men, a history of prostate cancer was associated with higher V1 WF scores (β = 0.29, SE = 0.12; p = 0.02) and predicted increases in SEVLT-Sum (β = 0.46, SE = 0.22; p = 0.04) from V1 to V2.
CONCLUSION
Among women, a history of cervical cancer was associated with 7-year memory decline, which may reflect the impacts of systemic cancer therapies. Among men, however, a history of prostate cancer was associated with improvements in cognitive performance, perhaps due in part to engaging in health promoting behaviors following cancer.
背景
癌症患者和幸存者经常经历急性认知障碍；然而，长期的认知影响仍不清楚，特别是在西班牙裔/拉丁裔中。我们研究了癌症史与中年和老年西班牙裔/拉丁裔人群神经认知测试表现之间的关系。
方法
参与者包括来自社区为基础和前瞻性西班牙裔社区健康研究/拉丁裔研究的 9639 名西班牙裔/拉丁裔成年人。在基线（2008-2011 年；V1）时，参与者自我报告了他们的癌症史。在 V1 时，以及在 7 年的随访时（2015-2018 年；V2），经过培训的技术人员进行了神经认知测试，包括简短西班牙语英语词汇学习测试（B-SEVLT）、词汇流畅性测试（WF）和数字符号替代测试（DSS）。我们使用调查线性回归来估计癌症史与 V1 时的神经认知测试表现之间的总体、性别特异性和癌症部位特异性（即宫颈、乳房、子宫和前列腺）调整关联，以及从 V1 到 V2 的变化。
结果
在 V1 时，癌症史（6.4%）与无癌症史（93.6%）相比，WF 评分较高（β=0.14，SE=0.06；p=0.03）和整体认知较高（β=0.09，SE=0.04；p=0.04）。在女性中，宫颈癌史预测了从 V1 到 V2 的 SEVLT-Recall 评分下降（β=-0.31，SE=0.13；p=0.02），而在男性中，前列腺癌史与 V1 WF 评分较高相关（β=0.29，SE=0.12；p=0.02），并预测了从 V1 到 V2 的 SEVLT-Sum 增加（β=0.46，SE=0.22；p=0.04）。
结论
在女性中，宫颈癌史与 7 年记忆衰退有关，这可能反映了全身癌症治疗的影响。然而，在男性中，前列腺癌史与认知表现的改善有关，这可能部分归因于癌症后采取了促进健康的行为。
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