Sleep disturbance and neurocognitive outcomes in older patients with breast cancer: Interaction with genotype.
Aged
Aged, 80 and over
Alleles
Apolipoprotein E4
/ genetics
Breast Neoplasms
/ complications
Cognition Disorders
/ diagnosis
Comorbidity
Disease Susceptibility
Female
Genetic Association Studies
Genetic Predisposition to Disease
Genotype
Humans
Learning
Memory
Middle Aged
Neuropsychological Tests
Self Concept
Sleep Wake Disorders
/ diagnosis
APOE
BDNF
COMT
breast cancer
cognition
genotype
older
sleep
Journal
Cancer
ISSN: 1097-0142
Titre abrégé: Cancer
Pays: United States
ID NLM: 0374236
Informations de publication
Date de publication:
15 12 2019
15 12 2019
Historique:
received:
24
01
2019
revised:
03
06
2019
accepted:
09
07
2019
pubmed:
26
9
2019
medline:
27
5
2020
entrez:
26
9
2019
Statut:
ppublish
Résumé
Sleep disturbance and genetic profile are risks for cognitive decline in noncancer populations, yet their role in cancer-related cognitive problems remains understudied. This study examined whether sleep disturbance was associated with worse neurocognitive outcomes in breast cancer survivors and whether sleep effects on cognition varied by genotype. Newly diagnosed female patients (n = 319) who were 60 years old or older and had stage 0 to III breast cancer were recruited from August 2010 to December 2015. Assessments were performed before systemic therapy and 12 and 24 months later. Neuropsychological testing measured attention, processing speed, executive function, learning, and memory; self-perceived cognitive functioning was also assessed. Sleep disturbance was defined by self-report of routine poor or restless sleep. Genotyping included APOE, BDNF, and COMT polymorphisms. Random effects fluctuation models tested associations of between-person and within-person differences in sleep, genotype, and sleep-genotype interactions and cognition and controlled for age, reading level, race, site, and treatment. One-third of the patients reported sleep disturbances at each time point. There was a sleep-APOE ε4 interaction (P = .001) in which patients with the APOE ε4 allele and sleep disturbances had significantly lower learning and memory scores than those who were APOE ε4-negative and without sleep disturbances. There was also a sleep disturbance-COMT genotype interaction (P = .02) in which COMT Val carriers with sleep disturbances had lower perceived cognition than noncarriers. Sleep disturbance was common and was associated with worse cognitive performance in older breast cancer survivors, especially those with a genetic risk for cognitive decline. Survivorship care should include sleep assessments and interventions to address sleep problems.
Sections du résumé
BACKGROUND
Sleep disturbance and genetic profile are risks for cognitive decline in noncancer populations, yet their role in cancer-related cognitive problems remains understudied. This study examined whether sleep disturbance was associated with worse neurocognitive outcomes in breast cancer survivors and whether sleep effects on cognition varied by genotype.
METHODS
Newly diagnosed female patients (n = 319) who were 60 years old or older and had stage 0 to III breast cancer were recruited from August 2010 to December 2015. Assessments were performed before systemic therapy and 12 and 24 months later. Neuropsychological testing measured attention, processing speed, executive function, learning, and memory; self-perceived cognitive functioning was also assessed. Sleep disturbance was defined by self-report of routine poor or restless sleep. Genotyping included APOE, BDNF, and COMT polymorphisms. Random effects fluctuation models tested associations of between-person and within-person differences in sleep, genotype, and sleep-genotype interactions and cognition and controlled for age, reading level, race, site, and treatment.
RESULTS
One-third of the patients reported sleep disturbances at each time point. There was a sleep-APOE ε4 interaction (P = .001) in which patients with the APOE ε4 allele and sleep disturbances had significantly lower learning and memory scores than those who were APOE ε4-negative and without sleep disturbances. There was also a sleep disturbance-COMT genotype interaction (P = .02) in which COMT Val carriers with sleep disturbances had lower perceived cognition than noncarriers.
CONCLUSIONS
Sleep disturbance was common and was associated with worse cognitive performance in older breast cancer survivors, especially those with a genetic risk for cognitive decline. Survivorship care should include sleep assessments and interventions to address sleep problems.
Identifiants
pubmed: 31553501
doi: 10.1002/cncr.32489
pmc: PMC6891125
mid: NIHMS1045955
doi:
Substances chimiques
Apolipoprotein E4
0
Banques de données
ClinicalTrials.gov
['NCT03451383']
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
4516-4524Subventions
Organisme : NCI NIH HHS
ID : U54 CA137788
Pays : United States
Organisme : NCI NIH HHS
ID : T32 CA117865
Pays : United States
Organisme : American Cancer Society
ID : 128660-RSG-15-187-01-PCSM
Pays : International
Organisme : NCI NIH HHS
ID : R01CA129769
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA129769
Pays : United States
Organisme : NCI NIH HHS
ID : F31 CA220964
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG068193
Pays : United States
Organisme : NCI NIH HHS
ID : R35 CA197289
Pays : United States
Organisme : NCI NIH HHS
ID : P30CA51008
Pays : United States
Organisme : NIH HHS
ID : R01CA172119
Pays : United States
Organisme : NCI NIH HHS
ID : P30AG10133
Pays : United States
Organisme : NCI NIH HHS
ID : R01LM01136
Pays : United States
Organisme : NIA NIH HHS
ID : R01 AG019771
Pays : United States
Organisme : NCI NIH HHS
ID : R01CA172119
Pays : United States
Organisme : NIA NIH HHS
ID : P30 AG010133
Pays : United States
Organisme : NCI NIH HHS
ID : R01 CA172119
Pays : United States
Organisme : NCI NIH HHS
ID : R35CA197289
Pays : United States
Organisme : NCI NIH HHS
ID : R01AG19771
Pays : United States
Organisme : NCI NIH HHS
ID : F31CA220964
Pays : United States
Organisme : NIH HHS
ID : R01LM01136
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Organisme : NIH HHS
ID : P30AG10133
Pays : United States
Organisme : NLM NIH HHS
ID : R01 LM011360
Pays : United States
Organisme : NCI NIH HHS
ID : T32CA117865
Pays : United States
Organisme : NIH HHS
ID : R01AG19771
Pays : United States
Organisme : NCI NIH HHS
ID : U54 CA132378
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA051008
Pays : United States
Informations de copyright
© 2019 American Cancer Society.
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