Clinical Factors Associated With Cancer-Related Cognitive Impairment in Breast Cancer Patients in Malaysia.

Abstract

Background: Cancer-related cognitive impairment (CRCI) is an increasingly acknowledged after-effect of breast cancer and its treatment. However, its associated risk factors remain vaguely understood. This study aimed to examine the factors influencing cognitive functions in the Malaysia breast cancer population, along with the correlation between perceived and objective cognitive functioning among subjects.

Methods: This is a cross-sectional study among breast cancer patients from University Malaya Medical Centre, a teaching hospital in Kuala Lumpur, Malaysia. Subjects were assessed using socio-demographic and clinical questionnaires, Digit Symbol Substitution Test (DSST), Perceived Deficit Questionnaire 5-Malay version (PDQ5-M), Positive Emotion Rating Scale-Malay version (PERS-M), and Hospital anxiety and depression scale Malay version (HADS-M).

Results: Lower education level (p<0.001, partial eta² 0.066) and presence of chronic illness (p=0.027, partial eta² 0.027) were associated with poorer DSST performance. Subjects with higher anxiety levels were observed to have more subjective cognitive concerns, which manifested as higher PDQ5-M score (p<0.001, partial eta² 0.085). The chemotherapy approach and time since completion of chemotherapy were reported to have no significant association with cognitive performance. There was a reported disparity between subjective and objective measure.

Conclusion: There is a significant discrepancy between subjective and objective cognitive function assessments.  Subjective cognitive concerns were found to be related to psychological distress, whereas those with lower education level and chronic illness had a significant poorer objective cognitive performance. An adequate assessment of cognitive function for breast cancer patients should include both objective and subjective measures as they are not interchangeable.