Influencing factors of chemotherapy-related cognitive impairment in patients with breast cancer

Abstract

Introduction: The chemotherapy-related cognitive impairment is common, but the influencing factors and effective intervention measures are not well known.

Objective: To investigate the changes of cognitive function in breast cancer patients before and after chemotherapy, identify the influencing factors of cognitive function in chemotherapy patients, and investigate whether there is a mediating effect among multiple factors. Finally, an intervention was implemented for patients experiencing cognitive dysfunction to evaluate its effects on cognitive function.

Methods: Using the convenience sampling method, we recruited 380 breast cancer chemotherapy patients at three tertiary hospitals in Xi’an from October 2018 to May 2019. The Chinese version of the Functional Assessment of Cancer Therapy-Cognitive Function scale, the Hamilton Anxiety Scale, the Hamilton Depression Scale, and the social support rating scale were used to evaluate the cognitive function of breast cancer patients during chemotherapy, and analyze the influencing factors of cognitive function.

Results: The incidence of chemotherapy-related cognitive dysfunction in breast cancer patients was 19.74% (75/380). The results of the univariate analysis showed that the education level, medical expense payment method, family history of breast cancer, disease stage, and presence of comorbidities could impact cognitive functioning in breast cancer patients receiving chemotherapy (p<0.05). Correlation analysis revealed that there was a negative correlation among cognitive function and anxiety and depression (p<0.01), while a positive correlation with social support (p<0.05). Furthermore, multivariate stepwise regression analysis showed that the education level, medical expense payment method, disease stage, depression, and social support were independent influencing factors of cognitive function in breast cancer patients receiving chemotherapy and that depressive symptoms had a mediating effect in the relationship between social support and cognitive function. Cognitive has been shown to have a positive impact on cognitive function.

Conclusion: Cognitive dysfunction in breast cancer patients receiving chemotherapy is a multifactorial condition that requires rigorous educational and social support interventions for improvements of patient outcomes.

Keywords

Breast cancer / Chemotherapy / Chemotherapy-related cognitive impairment

Funding

This research was funded by the Beijing Sisco Clinical Oncology Research Fund (grant number Y-L2020-0013), the Shaanxi Clinical Medical Research Center for Breast Diseases (grant number 2024SF-LCZX-08), the Natural Science Basic Research Program of Shaanxi Province (grant number 2023-JC-YB-345), Shaanxi Provincial People’s Hospital Elite Talent Project (grant number 2022-JY46), and the Shaanxi Provincial People’s Hospital incubation fund project (grant number 2022YJY-57).

Conflict of interest

The authors declare no conflicts of interest.

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