Albers E A C, Kieffer J M, Schagen S B
Divison of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands.
J Cancer Surviv. 2024 Apr 26. doi: 10.1007/s11764-024-01608-0.
Breast cancer patients receiving chemotherapy can develop cognitive impairment. There is no gold standard for defining cognitive impairment. We applied the National Institute on Aging-Alzheimer's Association (NIA-AA) criteria for mild cognitive impairment (MCI) to determine its prevalence in breast cancer patients receiving adjuvant chemotherapy and examine differences between patients with and without MCI.
We used pre-existing cognitive data on 5 neuropsychological test outcomes (verbal memory, processing speed, executive functioning, and verbal fluency) gathered from 240 breast cancer patients who received adjuvant conventional (n = 154) or high-dose chemotherapy (n = 86). Assessments occurred 6 or 12 months post-chemotherapy and results were compared with data from 66 women without cancer. MCI was defined by the following: (i) presence of concern regarding a change in cognition, (ii) impairment in one or more cognitive tests (1.5 standard deviation below a normative mean), (iii) preservation of independence in functional abilities, and (iv) the absence of dementia.
Twenty percent (n = 49) of breast cancer patients who received chemotherapy (conventional therapy n = 29 (12%), high-dose therapy = 20 (8.3%)) met the criteria for MCI, compared with 7.6% (n = 5) of controls. Prevalence was significantly different between patients and controls (P = 0.020, and corrected for IQ P < 0.001). Patients with MCI had significant lower education levels (P < 0.002) and premorbid IQ (P = 0.001) compared with patients without MCI.
Twenty percent of breast cancer patients treated with chemotherapy met NIA-AA criteria for MCI, compared with 7.6% of the controls.
These criteria, which include formal test performance as well as a person's symptoms and functional status, can be useful in clinical practice and scientific research.
接受化疗的乳腺癌患者可能会出现认知障碍。目前尚无定义认知障碍的金标准。我们应用美国国立衰老研究所-阿尔茨海默病协会（NIA-AA）的轻度认知障碍（MCI）标准来确定其在接受辅助化疗的乳腺癌患者中的患病率，并检查有MCI和无MCI患者之间的差异。
我们使用了从240例接受辅助常规化疗（n = 154）或高剂量化疗（n = 86）的乳腺癌患者中收集的关于5项神经心理学测试结果（言语记忆、处理速度、执行功能和言语流畅性）的既往认知数据。评估在化疗后6或12个月进行，并将结果与66名无癌症女性的数据进行比较。MCI的定义如下：（i）存在对认知变化的担忧，（ii）一项或多项认知测试受损（低于正常均值1.5个标准差），（iii）功能能力保持独立，以及（iv）无痴呆。
接受化疗的乳腺癌患者中有20%（n = 49）（常规治疗n = 29（12%），高剂量治疗 = 20（8.3%））符合MCI标准，而对照组为7.6%（n = 5）。患者和对照组之间的患病率有显著差异（P = 0.020，经智商校正后P < 0.001）。与无MCI的患者相比，有MCI的患者教育水平显著较低（P < 0.002）且病前智商较低（P = 0.001）。
接受化疗的乳腺癌患者中有20%符合NIA-AA的MCI标准，而对照组为7.6%。
这些标准包括正式测试表现以及个人症状和功能状态，在临床实践和科学研究中可能有用。
