Trajectories of Cognitive Function Prior to Cancer Diagnosis: A Population-Based Study.
Journal
Journal of the National Cancer Institute
ISSN: 1460-2105
Titre abrégé: J Natl Cancer Inst
Pays: United States
ID NLM: 7503089
Informations de publication
Date de publication:
01 05 2020
01 05 2020
Historique:
received:
09
04
2019
revised:
25
07
2019
accepted:
04
09
2019
pubmed:
10
9
2019
medline:
9
1
2021
entrez:
10
9
2019
Statut:
ppublish
Résumé
An emerging body of research suggests that noncentral nervous system cancer may negatively impact the brain apart from effects of cancer treatment. However, studies assessing cognitive function in newly diagnosed cancer patients cannot exclude selection bias and psychological effects of cancer diagnosis. To overcome these limitations, we investigated trajectories of cognitive function of patients before cancer diagnosis. Between 1989 and 2013, a total of 2059 participants from the population-based Rotterdam Study were diagnosed with noncentral nervous system cancer. Cognitive assessments were performed every 3 to 5 years using a neuropsychological battery. The general cognitive factor was composed of individual cognitive tests to assess global cognition. Using linear mixed models, we compared change in cognitive function of cancer case patients before diagnosis with cognitive change of age-matched cancer-free control subjects (1:2). In addition, we performed sensitivity analyses by discarding assessments of control subjects 5 years before the end of follow-up to exclude effects from potential undiagnosed cancer. All statistical tests were two-sided. The Word Learning Test immediate recall declined faster among case patients than among control subjects (-0.05, 95% confidence interval = -0.09 to -0.01 vs 0.01, 95% confidence interval = -0.01 to 0.03; P for difference = .003). However, this difference was not statistically significant in sensitivity analyses. Furthermore, no statistically significant differences were observed in change of other individual cognitive tests and of the general cognitive factor. In this study, we evaluated cognitive function in a large group of cancer patients prior to diagnosis, thereby excluding the psychological impact of cancer diagnosis and biased patient selection. In contrast to previous studies shortly after cancer diagnosis, we found no difference in change of cognitive function between cancer patients and control subjects.
Sections du résumé
BACKGROUND
An emerging body of research suggests that noncentral nervous system cancer may negatively impact the brain apart from effects of cancer treatment. However, studies assessing cognitive function in newly diagnosed cancer patients cannot exclude selection bias and psychological effects of cancer diagnosis. To overcome these limitations, we investigated trajectories of cognitive function of patients before cancer diagnosis.
METHODS
Between 1989 and 2013, a total of 2059 participants from the population-based Rotterdam Study were diagnosed with noncentral nervous system cancer. Cognitive assessments were performed every 3 to 5 years using a neuropsychological battery. The general cognitive factor was composed of individual cognitive tests to assess global cognition. Using linear mixed models, we compared change in cognitive function of cancer case patients before diagnosis with cognitive change of age-matched cancer-free control subjects (1:2). In addition, we performed sensitivity analyses by discarding assessments of control subjects 5 years before the end of follow-up to exclude effects from potential undiagnosed cancer. All statistical tests were two-sided.
RESULTS
The Word Learning Test immediate recall declined faster among case patients than among control subjects (-0.05, 95% confidence interval = -0.09 to -0.01 vs 0.01, 95% confidence interval = -0.01 to 0.03; P for difference = .003). However, this difference was not statistically significant in sensitivity analyses. Furthermore, no statistically significant differences were observed in change of other individual cognitive tests and of the general cognitive factor.
CONCLUSIONS
In this study, we evaluated cognitive function in a large group of cancer patients prior to diagnosis, thereby excluding the psychological impact of cancer diagnosis and biased patient selection. In contrast to previous studies shortly after cancer diagnosis, we found no difference in change of cognitive function between cancer patients and control subjects.
Identifiants
pubmed: 31498410
pii: 5566247
doi: 10.1093/jnci/djz178
pmc: PMC7225679
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
480-488Commentaires et corrections
Type : CommentIn
Informations de copyright
© The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Références
J Neurol Neurosurg Psychiatry. 2006 Mar;77(3):308-16
pubmed: 16484637
Am J Epidemiol. 2007 Aug 15;166(4):367-78
pubmed: 17573335
Cancer. 2007 May 1;109(9):1905-13
pubmed: 17351951
Curr Neurol Neurosci Rep. 2012 Jun;12(3):267-75
pubmed: 22453825
Arch Clin Neuropsychol. 2018 Dec 1;33(8):956-963
pubmed: 29471454
Neuroscience. 2018 Jan 15;369:51-65
pubmed: 29113931
Int Rev Psychiatry. 2014 Feb;26(1):102-13
pubmed: 24716504
J Clin Psychol. 1988 May;44(3):403-11
pubmed: 3384968
Head Neck. 2018 Sep;40(9):2029-2042
pubmed: 29667262
Lancet. 2002 Jan 26;359(9303):281-6
pubmed: 11830193
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
Neurology. 2002 Aug 13;59(3):364-70
pubmed: 12177369
J Neuroimmunol. 2016 Dec 15;301:74-82
pubmed: 27890459
Brain Behav Immun. 2014 Feb;36:147-55
pubmed: 24513875
JAMA Oncol. 2018 May 1;4(5):686-693
pubmed: 29494732
PLoS One. 2008;3(11):e3639
pubmed: 18982064
Brain Behav. 2017 Feb 06;7(3):e00643
pubmed: 28293478
J Clin Oncol. 2012 Oct 20;30(30):3675-86
pubmed: 23008308
Psychooncology. 2004 Aug;13(8):562-76
pubmed: 15295777
Lancet. 2005 Nov 19;366(9499):1784-93
pubmed: 16298215
J Int Neuropsychol Soc. 2006 Jan;12(1):80-9
pubmed: 16433947
J Appl Psychol. 1948 Jun;32(3):234-47
pubmed: 18867059
Exp Aging Res. 1993 Jul-Sep;19(3):209-24
pubmed: 8223823
J Natl Cancer Inst. 2015 Jun 22;107(8):
pubmed: 26101331
J Natl Cancer Inst. 1998 Dec 16;90(24):1888-93
pubmed: 9862626
Eur J Epidemiol. 2014 Feb;29(2):133-40
pubmed: 24553905
Eur J Epidemiol. 2017 Sep;32(9):807-850
pubmed: 29064009
Annu Rev Clin Psychol. 2018 May 7;14:425-451
pubmed: 29345974
Br J Cancer. 2008 Nov 4;99(9):1408-14
pubmed: 18941462
J Clin Exp Neuropsychol. 2006 Aug;28(6):998-1009
pubmed: 16822738
PLoS One. 2013 Jun 14;8(6):e65841
pubmed: 23799051
PLoS One. 2016 Feb 11;11(2):e0148908
pubmed: 26867138
Alzheimers Dement. 2014 Oct;10(5 Suppl):S323-S329.e1
pubmed: 24530024
JAMA Otolaryngol Head Neck Surg. 2018 Nov 1;144(11):978-987
pubmed: 29710116
Brain Behav Immun. 2010 Aug;24(6):903-7
pubmed: 20188817
J Am Med Womens Assoc (1972). 1992 Sep-Oct;47(5):161-4
pubmed: 1460219
Lancet Oncol. 2011 Jul;12(7):703-8
pubmed: 21354373
J Clin Oncol. 2012 Apr 1;30(10):1080-6
pubmed: 22370315