Longitudinal Analysis of Patient-Reported Cognitive Function in Multiple Myeloma.
Cancer-related cognitive dysfunction
Cancer-related cognitive impairment
Cognitive reserve
Multiple myeloma
Patient-reported outcomes
Journal
Clinical lymphoma, myeloma & leukemia
ISSN: 2152-2669
Titre abrégé: Clin Lymphoma Myeloma Leuk
Pays: United States
ID NLM: 101525386
Informations de publication
Date de publication:
12 2022
12 2022
Historique:
received:
13
05
2022
revised:
14
07
2022
accepted:
10
08
2022
pubmed:
10
9
2022
medline:
29
11
2022
entrez:
9
9
2022
Statut:
ppublish
Résumé
Cancer-related cognitive impairment (CRCI) has been largely unstudied in patients with multiple myeloma (MM). This study describes patient-reported cognition over time and patient factors associated with adverse cognitive outcomes in MM. Participants enrolled in a registry in which they completed a geriatric assessment at study entry, and 3 & 6 months after entry. Cognitive function was assessed using the EORTC QLQ-C30 Cognitive Function subscale, with CRCI defined as scores < 75. Generalized estimating equation (GEE) models were used to fit longitudinal models to investigate differences by group and differences in changes over time by group, with adjustment for time since diagnosis. One hundred and four adults with MM had mean age of 67 years and 30% identified as Black. Patient-reported CRCI was present in 18% of participants at enrollment, 21% at 3 months, and 30% at 6 months. Worse cognitive function was reported in those with impairments in physical function (P = .002), IADLs (P = .02), and performance status (P = .04), as well as in those who were prefrail/frail (P = .02) and depressed (P = .049). Greater cognitive decline over time was observed in patients without CRCI at enrollment (P < .0001) and those with lower levels of education (P = .04). This is one of the first studies to describe longitudinal changes in patient-reported cognition in patients with MM. Several potentially intervenable factors, including physical function impairment and depression, were associated with worse cognition at study entry, but only baseline CRCI status and education level were predictive of future decline.
Sections du résumé
BACKGROUND
Cancer-related cognitive impairment (CRCI) has been largely unstudied in patients with multiple myeloma (MM). This study describes patient-reported cognition over time and patient factors associated with adverse cognitive outcomes in MM.
METHODS
Participants enrolled in a registry in which they completed a geriatric assessment at study entry, and 3 & 6 months after entry. Cognitive function was assessed using the EORTC QLQ-C30 Cognitive Function subscale, with CRCI defined as scores < 75. Generalized estimating equation (GEE) models were used to fit longitudinal models to investigate differences by group and differences in changes over time by group, with adjustment for time since diagnosis.
RESULTS
One hundred and four adults with MM had mean age of 67 years and 30% identified as Black. Patient-reported CRCI was present in 18% of participants at enrollment, 21% at 3 months, and 30% at 6 months. Worse cognitive function was reported in those with impairments in physical function (P = .002), IADLs (P = .02), and performance status (P = .04), as well as in those who were prefrail/frail (P = .02) and depressed (P = .049). Greater cognitive decline over time was observed in patients without CRCI at enrollment (P < .0001) and those with lower levels of education (P = .04).
CONCLUSION
This is one of the first studies to describe longitudinal changes in patient-reported cognition in patients with MM. Several potentially intervenable factors, including physical function impairment and depression, were associated with worse cognition at study entry, but only baseline CRCI status and education level were predictive of future decline.
Identifiants
pubmed: 36085276
pii: S2152-2650(22)00256-7
doi: 10.1016/j.clml.2022.08.002
pmc: PMC9691560
mid: NIHMS1836797
pii:
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
920-927Subventions
Organisme : NCI NIH HHS
ID : K12 CA120780
Pays : United States
Organisme : NCI NIH HHS
ID : T32 CA233419
Pays : United States
Organisme : NICHD NIH HHS
ID : K12 HD001441
Pays : United States
Organisme : NIA NIH HHS
ID : R03 AG074030
Pays : United States
Organisme : NIA NIH HHS
ID : T35 AG038047
Pays : United States
Informations de copyright
Copyright © 2022. Published by Elsevier Inc.
Références
J Clin Oncol. 1994 Mar;12(3):601-7
pubmed: 8120560
Psychopharmacology (Berl). 2011 May;215(1):105-15
pubmed: 21181126
J Clin Oncol. 2010 Oct 10;28(29):4434-40
pubmed: 20837957
J Natl Cancer Inst. 1993 Mar 3;85(5):365-76
pubmed: 8433390
Biomed Res Int. 2016;2016:1820954
pubmed: 27144158
J Geriatr Oncol. 2022 Sep;13(7):987-996
pubmed: 35484067
J Geriatr Oncol. 2022 Jan;13(1):27-32
pubmed: 34366276
J Geriatr Oncol. 2019 Mar;10(2):241-245
pubmed: 30205939
Cancer. 2022 Mar 01;128(5):1101-1109
pubmed: 34762734
Phys Ther. 2000 Sep;80(9):896-903
pubmed: 10960937
J Am Geriatr Soc. 2019 May;67(5):928-936
pubmed: 31034595
Cancer. 2013 Dec 1;119(23):4188-95
pubmed: 24105672
Psychooncology. 2010 Nov;19(11):1127-38
pubmed: 20020424
JMIR Cancer. 2019 Oct 11;5(2):e13150
pubmed: 31605514
Support Care Cancer. 2022 Jan;30(1):711-720
pubmed: 34368888
J Geriatr Oncol. 2020 Mar;11(2):297-303
pubmed: 31831362
JNCI Cancer Spectr. 2019 Jun 04;3(3):pkz037
pubmed: 32328553
JAMA Oncol. 2018 May 1;4(5):686-693
pubmed: 29494732
CA Cancer J Clin. 2017 Sep;67(5):362-377
pubmed: 28731537
Clin Lymphoma Myeloma Leuk. 2019 Aug;19(8):488-496.e6
pubmed: 31133527
Eur J Haematol. 2016 Nov;97(5):416-429
pubmed: 27528496
Biol Blood Marrow Transplant. 2020 Aug;26(8):1497-1504
pubmed: 32447045
J Natl Compr Canc Netw. 2017 Jul;15(7):894-902
pubmed: 28687577
Med Sci Monit. 2014 Jul 22;20:1267-73
pubmed: 25047152
Annu Rev Clin Psychol. 2018 May 7;14:425-451
pubmed: 29345974
Eur J Cancer Care (Engl). 2012 Jul;21(4):485-92
pubmed: 22211832
JAMA Oncol. 2016 Oct 1;2(10):1263-1264
pubmed: 27441735
J Natl Cancer Inst. 2021 Nov 29;113(12):1625-1633
pubmed: 33638633
J Am Geriatr Soc. 2019 May;67(5):987-991
pubmed: 30548581
Int J Clin Health Psychol. 2019 May;19(2):97-106
pubmed: 31193118
J Gerontol. 1981 Jul;36(4):428-34
pubmed: 7252074
Br J Haematol. 2021 Jul;194(1):132-139
pubmed: 33822368
Asia Pac J Clin Oncol. 2014 Jun;10(2):109-17
pubmed: 23551530
J Natl Compr Canc Netw. 2018 Mar;16(3):301-309
pubmed: 29523669
J Clin Epidemiol. 2020 Feb;118:1-8
pubmed: 31639445
Cancer. 2016 Nov 15;122(22):3555-3563
pubmed: 27447359
Psychooncology. 2019 Jan;28(1):167-173
pubmed: 30353629
Blood Adv. 2020 Jun 23;4(12):2810-2820
pubmed: 32574365
Eur J Oncol Nurs. 2017 Apr;27:53-59
pubmed: 28027862
Med Sci (Basel). 2021 Jan 20;9(1):
pubmed: 33498356
Ann Oncol. 2011 Sep;22(9):2107-2112
pubmed: 21324954
Cancer Treat Rev. 2012 Nov;38(7):926-34
pubmed: 22658913
BMC Cancer. 2020 Mar 3;20(1):169
pubmed: 32126972