Associations between Lifestyle Factors and Neurocognitive Impairment among Chinese Adolescent and Young Adult (AYA) Survivors of Sarcoma in Hong Kong
Refereed conference paper presented and published in conference proceedings
CUHK Authors
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AbstractBackground: The effect of lifestyle on neurocognitive impairment among cancer survivors remain an understudied area. This study explored the association between lifestyle factors and neurocognitive outcomes in AYA survivors (aged 15–39 years) of sarcoma.
Methods: This study recruited 116 AYA survivors (age 28.2 [SD=8.2] years), who were diagnosed with osteosarcoma (49%) or soft-tissue sarcoma (51%) at age 13.3 (SD=7.2) years. The neurocognitive battery included measures of attention, memory, motor-processing speed, and cognitive flexibility. Survivors reported health-damaging practices, which included: physical inactivity, smoking, alcohol intake, inadequate sleep (<7 hours of actual sleep/day), sleep-related fatigue (Multidimensional Fatigue Scale) and long working hours (>9 hours/day). General linear modeling was conducted to examine the association between lifestyle factors and neurocognitive outcomes, adjusting for age, sex and education attainment.
Results: At 14.9 [SD=7.6] years post-diagnosis, survivors demonstrated impairment in attentiveness (4.3-13.0%), processing speed (34.5%) and cognitive flexibility (18.1%). Nearly half (45.7%) had developed a chronic health condition (CHC). Low physical activity (β=-0.85, P=0.003) and sleep-related fatigue (β=-0.09, P=0.002) were associated with inattention. Survivors who worked >9 hours/day demonstrated worse sustained attention (β=5.36, P=0.024) and cognitive flexibility (β=5.27, P=0.005). Interaction analysis (CHCs*physical activity) showed that survivors who developed CHCs and reported low physical activity had worse attention (P=0.032) and cognitive flexibility (P=0.019) scores than other subgroups.
Conclusion: Treatment-related CHCs, coupled with continued physical inactivity, may exacerbate inattention and executive dysfunction among survivors. Long working hours and sleep-related fatigue are associated with worse functioning; this finding should be validated with prospective assessment of work-related stressors and objective sleep measures.
Methods: This study recruited 116 AYA survivors (age 28.2 [SD=8.2] years), who were diagnosed with osteosarcoma (49%) or soft-tissue sarcoma (51%) at age 13.3 (SD=7.2) years. The neurocognitive battery included measures of attention, memory, motor-processing speed, and cognitive flexibility. Survivors reported health-damaging practices, which included: physical inactivity, smoking, alcohol intake, inadequate sleep (<7 hours of actual sleep/day), sleep-related fatigue (Multidimensional Fatigue Scale) and long working hours (>9 hours/day). General linear modeling was conducted to examine the association between lifestyle factors and neurocognitive outcomes, adjusting for age, sex and education attainment.
Results: At 14.9 [SD=7.6] years post-diagnosis, survivors demonstrated impairment in attentiveness (4.3-13.0%), processing speed (34.5%) and cognitive flexibility (18.1%). Nearly half (45.7%) had developed a chronic health condition (CHC). Low physical activity (β=-0.85, P=0.003) and sleep-related fatigue (β=-0.09, P=0.002) were associated with inattention. Survivors who worked >9 hours/day demonstrated worse sustained attention (β=5.36, P=0.024) and cognitive flexibility (β=5.27, P=0.005). Interaction analysis (CHCs*physical activity) showed that survivors who developed CHCs and reported low physical activity had worse attention (P=0.032) and cognitive flexibility (P=0.019) scores than other subgroups.
Conclusion: Treatment-related CHCs, coupled with continued physical inactivity, may exacerbate inattention and executive dysfunction among survivors. Long working hours and sleep-related fatigue are associated with worse functioning; this finding should be validated with prospective assessment of work-related stressors and objective sleep measures.
Acceptance Date09/12/2022
All Author(s) ListYin Ting Cheung, Justin Chung Tin Ma, Michael Can Heng Li, Keary Rui Zhou, Herbert Ho Fung Loong, Agnes Sui Yin Chan, Kwok Chuen Wong, Chi Kong Li
Name of ConferenceInternational Cognition and Cancer Task Force Biennial Scientific Meeting
Start Date of Conference30/01/2023
End Date of Conference31/01/2023
Place of ConferenceSan Diego
Country/Region of ConferenceUnited States of America
Proceedings TitleInternational Cognition and Cancer Task Force Biennial Scientific Meeting Proceedings
Year2023
Month1
LanguagesEnglish-United States
KeywordsOsteosarcoma, cognitive function, lifestyle factors, exercise, adolescent and young adult cancer, AYA cancer
