XiuCen Wu, GuiHua Chen, Qin Li, Huan Tang, HuaPeng Shen
School of Nursing, Chongqing Medical University, Chongqing, China.
Nursing Department, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Brain Behav. 2025 Jun;15(6):e70594. doi: 10.1002/brb3.70594.
To investigate the potential factors contributing to chemotherapy-related cognitive impairment in elderly lung cancer patients and to offer insights for the creation of an intervention program aimed at enhancing the cognitive abilities of this vulnerable population.
Three hundred thirty-eight lung cancer patients from the departments of respiratory medicine, oncology, and thoracic surgery of two tertiary-level hospitals in Chongqing from July 2023 to July 2024 were selected for the study via convenience sampling. A self-designed General and Disease-Related Information Questionnaire, Hospital Anxiety and Depression Scale (HADS), Brief Fatigue Inventory (BFI), Pittsburgh Sleep Quality Index (PSQI), Mini-Mental State Examination (MMSE), and Functional Assessment of Cancer Therapy Cognitive Function (Fact-Cog) were utilized for the questionnaire survey. Univariate analysis of variance and binary logistic regression were employed to analyze the factors influencing chemotherapy-related cognitive impairment in elderly lung cancer patients.
Of the 338 participants, 300 (88.8%) were male and 38 (11.2%) were female, and 227 (67.2%) were between the ages of 60-69 years. The prevalence of cognitive impairment measured using the FACT-Cog was 32.8%, and univariate analysis revealed that homeplace, drinking, the nature of occupation before retirement, tea-drinking habits, leisure activities, ADL, pet ownership, HADS, BFI, PSQI, education level, hemoglobin value, and insurance were statistically significant (p < 0.05). Multifactorial analysis demonstrated that education level of junior high school (OR = 0.056, p < 0.05), education level of high school/secondary school (OR = 0.035, p < 0.05), education level of bachelor's degree/tertiary school (OR = 0.028, p < 0.05), and hemoglobin (OR = 0.981, p = 0.006) were protective factors for CRCI. Additionally, the nature of occupation before retirement (OR = 0.387, p = 0.005) and leisure activities (OR = 0.342, p = 0.001) were also found to be protective factors. Conversely, diagnosed anxiety-depression (OR = 2.938, p = 0.003) and severe fatigue (OR = 3.465, p = 0.001) emerged as risk factors for CRCI.
CRCI is the result of the intricate interplay of multiple potential factors and complex mechanisms. Healthcare professionals need to develop personalized intervention plans for patients based on their unique influencing factors, aiming to mitigate the adverse effects of risk factors on patients' cognitive functions. This approach can enhance patients' sense of self-worth and satisfaction with life, ultimately improving the quality of life of elderly lung cancer patients in the long term.
探讨老年肺癌患者化疗相关认知障碍的潜在影响因素，并为制定旨在提高这一弱势群体认知能力的干预方案提供见解。
通过便利抽样，选取2023年7月至2024年7月重庆两家三级医院呼吸内科、肿瘤科和胸外科的338例肺癌患者进行研究。采用自行设计的一般及疾病相关信息问卷、医院焦虑抑郁量表（HADS）、简明疲劳量表（BFI）、匹兹堡睡眠质量指数（PSQI）、简易精神状态检查表（MMSE）以及癌症治疗功能评估认知功能量表（Fact-Cog）进行问卷调查。采用单因素方差分析和二元逻辑回归分析影响老年肺癌患者化疗相关认知障碍的因素。
338名参与者中，男性300名（88.8%），女性38名（11.2%），年龄在60 - 69岁之间的有227名（67.2%）。使用Fact-Cog量表测得的认知障碍患病率为32.8%，单因素分析显示籍贯、饮酒、退休前职业性质、饮茶习惯、休闲活动、日常生活活动能力、养宠物情况、HADS、BFI、PSQI、教育程度、血红蛋白值和医保情况具有统计学意义（p < 0.05）。多因素分析表明，初中教育程度（OR = 0.056，p < 0.05）、高中/中专教育程度（OR = 0.035，p < 0.05）、本科/大专教育程度（OR = 0.028，p < 0.05）和血红蛋白（OR = 0.981，p = 0.006）是化疗相关认知障碍的保护因素。此外，退休前职业性质（OR = 0.387，p = 0.005）和休闲活动（OR = 0.342，p = 0.001）也被发现是保护因素。相反，诊断为焦虑抑郁（OR = 2.938，p = 0.003）和严重疲劳（OR = 3.465，p = 0.001）是化疗相关认知障碍的危险因素。
化疗相关认知障碍是多种潜在因素和复杂机制相互作用的结果。医护人员需要根据患者独特的影响因素为其制定个性化干预计划，旨在减轻危险因素对患者认知功能的不利影响。这种方法可以增强患者的自我价值感和生活满意度，最终从长远上改善老年肺癌患者的生活质量。
