National Institute of Nursing Research, National Institutes of Health, Bethesda, Maryland, USA.
National Institutes of Health Library, National Institutes of Health, Bethesda, Maryland, USA.
Cancer Med. 2024 Jun;13(12):e7255. doi: 10.1002/cam4.7255.
Cancer-related cognitive impairment (CRCI) is a prevalent condition that significantly impacts the quality of life of individuals who receive cancer treatment. Clinical management of CRCI presents challenges due to the absence of a standardized assessment. This study identified clinically relevant phenotypic clusters of CRCI based on subjective and objective cognitive function scores.
In this cross-sectional study, participants were clustered using the VARCLUS™ based on subjective cognitive impairment assessed through the PROMIS® version 1.0 short-form subscales of cognitive abilities and cognitive concerns and the CANTAB Cambridge Cognition® scores, which included measures of visuospatial working memory capacity, visual episodic memory, new learning, working memory, executive function, and sustained attention. Each cluster's characteristics were described using demographics, physical and psychosocial factors (physical function, affect, optimism, and social support), and psychoneurological symptoms (anxiety, depression, fatigue, neuropathic pain, and sleep disturbance).
We obtained five clusters from a total of 414 participants, where 99% were female, and 93% were self-reported white. Clusters 4 and 5 showed the highest PROMIS® cognitive abilities and the lowest measures of cognitive concern, while Clusters 1 and 2 showed the lowest cognitive abilities and the highest cognitive concerns. Clusters 4 and 5 had higher education, income, employment, and higher scores in physical function, positive affect, optimism, and social support. Additionally, individuals in these clusters were less prone to experience severe cancer-related psychoneurological symptoms.
Our clustering approach, combining subjective and objective cognitive function information, shows promise in identifying phenotypes that hold clinical relevance for categorizing patient presentation of CRCI and facilitating individualized management strategies.
癌症相关认知障碍（CRCI）是一种普遍存在的病症，严重影响接受癌症治疗的个体的生活质量。由于缺乏标准化评估，CRCI 的临床管理存在挑战。本研究根据主观和客观认知功能评分，确定了 CRCI 的具有临床意义的表型聚类。
在这项横断面研究中，参与者根据主观认知障碍使用 VARCLUS™ 进行聚类，通过 PROMIS® 版本 1.0 短式认知能力和认知关注子量表以及 CANTAB Cambridge Cognition®评分进行评估，其中包括视觉空间工作记忆容量、视觉情节记忆、新学习、工作记忆、执行功能和持续性注意力的测量。使用人口统计学、身体和心理社会因素（身体功能、情感、乐观和社会支持）以及精神神经症状（焦虑、抑郁、疲劳、神经病理性疼痛和睡眠障碍）描述每个聚类的特征。
我们从总共 414 名参与者中获得了五个聚类，其中 99%为女性，93%自我报告为白人。聚类 4 和 5 显示了最高的 PROMIS®认知能力和最低的认知关注测量值，而聚类 1 和 2 则显示了最低的认知能力和最高的认知关注。聚类 4 和 5 具有较高的教育程度、收入、就业以及更高的身体功能、积极情感、乐观和社会支持评分。此外，这些聚类中的个体不太容易经历严重的癌症相关精神神经症状。
我们的聚类方法结合了主观和客观认知功能信息，有望识别具有临床意义的表型，用于对 CRCI 患者表现进行分类，并促进个体化管理策略的制定。
