Hartman Sheri J, Zablocki Rong W, Tam Rowena M, Palmer Barton W, Parker Barbara A, Sears Dorothy D, Ahles Tim A, Natarajan Loki
Herbert Wertheim School of Public Health, UC San Diego, La Jolla, CA, United States.
UC San Diego Moores Cancer Center, UC San Diego, La Jolla, CA, United States.
Front Cognit. 2024;3. doi: 10.3389/fcogn.2024.1332960. Epub 2024 May 9.
Cancer related cognitive decline is a common long-term side effect of cancer and its treatments among breast cancer survivors. Physical activity is a modifiable risk factor related to cognitive decline. However, existing research lacks consensus regarding the relationship between cognition and exercise as well as the impact of cancer treatments on this relationship. Baseline data from an ongoing randomized clinical trial was utilized to examine the relationship between self-reported and objectively measured cognition with physical activity. Exploratory analyses examined cancer treatments as potential moderators.
Breast cancer survivors ( = 253) completed a battery of neurocognitive tests, the PROMIS Cognitive abilities questionnaire, medical charts abstracted for treatment information, and wore an ActiGraph accelerometer at the waist for 7 days. Data were analyzed using multiple linear regression models.
Participants were on average 58.5 (SD = 8.88) years old, diagnosed 3 years prior to enrollment (SD = 1.27) with 57% treated with chemotherapy and 80% receiving hormone therapy at baseline. Better self-reported cognitive ability was significantly associated with greater min of moderate to vigorous physical activity (MVPA; β = 0.070, se = 0.028, = 0.012). There were no significant associations with any objectively measured cognitive domains. Time since diagnosis (years) was a significant moderator of MVPA and Processing Speed (β = -0.103, se = 0.043, = 0.017). Treatment with chemotherapy and/or hormones did not significantly moderate the relationship between MVPA and any of the cognitive measures or domains.
Findings suggest that physical activity is related to self-reported cognition but not objectively measured cognition. Greater physical activity was associated with faster processing speed in participants closer in time to their cancer diagnosis. These results emphasize the need for more research to understand when cancer survivors may benefit from physical activity and what aspects of cognition may be improved.
癌症相关认知功能衰退是乳腺癌幸存者中癌症及其治疗常见的长期副作用。身体活动是与认知功能衰退相关的一个可改变的风险因素。然而，现有研究在认知与运动之间的关系以及癌症治疗对这种关系的影响方面缺乏共识。利用一项正在进行的随机临床试验的基线数据来研究自我报告的认知和客观测量的认知与身体活动之间的关系。探索性分析将癌症治疗作为潜在的调节因素进行研究。
253名乳腺癌幸存者完成了一系列神经认知测试、PROMIS认知能力问卷、提取治疗信息的病历，并在腰部佩戴ActiGraph加速度计7天。使用多元线性回归模型对数据进行分析。
参与者平均年龄为58.5岁（标准差=8.88），在入组前3年被诊断（标准差=1.27），基线时57%接受化疗，80%接受激素治疗。自我报告的认知能力越好，与中度至剧烈身体活动（MVPA）分钟数越多显著相关（β=0.070，标准误=0.028，P=0.012）。与任何客观测量的认知领域均无显著关联。诊断后的时间（年）是MVPA和处理速度的显著调节因素（β=-0.1*03，标准误=0.043，P=0.017）。化疗和/或激素治疗并未显著调节MVPA与任何认知测量或领域之间的关系。
研究结果表明，身体活动与自我报告的认知相关，但与客观测量的认知无关。在癌症诊断时间较近的参与者中，更多的身体活动与更快的处理速度相关。这些结果强调需要更多研究来了解癌症幸存者何时可能从身体活动中获益以及认知的哪些方面可能得到改善。
