The Mediatory Role of Cancer-related Symptoms in Cognitive Complaints among Adolescents and Young Adults (AYAs) with Cancer
Refereed conference paper presented and published in conference proceedings
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AbstractIntroduction: AYA patients with cancer are at risk of developing cognitive problems due to cancer and treatment experience. This study identified the clinical, treatment, and behavioral risk factors of cognitive complaints in AYAs with cancer, and examined the mediatory effects of cancer-related symptoms.
Methods: This multi-centered study recruited AYAs (15 to 39 years old) diagnosed with cancer from two public hospitals in Hong Kong. They completed the Childhood Cancer Survivor Study-Neurocognitive Questionnaire to report cognitive complaints (memory, task efficiency, emotional regulation, and organization problems) that interfered with their daily functioning. The predictive factors of interest included clinical/treatment characteristics (from electronic health records), physical symptom burden (Rotterdam Symptom Checklist), and psychological symptoms (Brief Symptom Inventory-18). General linear modeling was conducted to identify factors associated with cognitive complaints, adjusted for age, sex, and cancer diagnoses. Mediation analysis was performed to examine the indirect effects of physical and psychological symptoms on cognitive complaints.
Results: This analysis included 305 AYA patients (41.3% male; mean [SD] age 32.7 [7.7] years) with cancer. AYA patients with comorbidities reported more memory (P=0.03) and task efficiency (P=0.02) problems than patients without comorbidities (Table 1). Immunotherapy (P =0.047) and radiotherapy (P =0.004) were associated with worse memory complaints. Patients treated with chemotherapy reported more severe organization problems (P=0.046). Higher physical and psychological symptom burdens were associated with complaints on multiple cognitive domains (Table 1). Mediation analyses showed that physical symptoms (ß=0.37, SE=0.16, P<0.001) were strong mediators between chemotherapy and cognitive complaints (Figure 1). However, psychological symptoms did not play a significant mediatory role (P=0.10).
Conclusion: Cancer-related physical symptoms are potential mediators between cancer treatment modalities and cognitive deficits in AYAs with cancer. This supports the importance of symptom management in improving functional outcomes in AYA patients, especially for patients with comorbidities and high symptom burden.
Methods: This multi-centered study recruited AYAs (15 to 39 years old) diagnosed with cancer from two public hospitals in Hong Kong. They completed the Childhood Cancer Survivor Study-Neurocognitive Questionnaire to report cognitive complaints (memory, task efficiency, emotional regulation, and organization problems) that interfered with their daily functioning. The predictive factors of interest included clinical/treatment characteristics (from electronic health records), physical symptom burden (Rotterdam Symptom Checklist), and psychological symptoms (Brief Symptom Inventory-18). General linear modeling was conducted to identify factors associated with cognitive complaints, adjusted for age, sex, and cancer diagnoses. Mediation analysis was performed to examine the indirect effects of physical and psychological symptoms on cognitive complaints.
Results: This analysis included 305 AYA patients (41.3% male; mean [SD] age 32.7 [7.7] years) with cancer. AYA patients with comorbidities reported more memory (P=0.03) and task efficiency (P=0.02) problems than patients without comorbidities (Table 1). Immunotherapy (P =0.047) and radiotherapy (P =0.004) were associated with worse memory complaints. Patients treated with chemotherapy reported more severe organization problems (P=0.046). Higher physical and psychological symptom burdens were associated with complaints on multiple cognitive domains (Table 1). Mediation analyses showed that physical symptoms (ß=0.37, SE=0.16, P<0.001) were strong mediators between chemotherapy and cognitive complaints (Figure 1). However, psychological symptoms did not play a significant mediatory role (P=0.10).
Conclusion: Cancer-related physical symptoms are potential mediators between cancer treatment modalities and cognitive deficits in AYAs with cancer. This supports the importance of symptom management in improving functional outcomes in AYA patients, especially for patients with comorbidities and high symptom burden.
Acceptance Date02/05/2023
All Author(s) ListChung Tin Justin Ma, Can Heng Li, Ching Yan Yau, Rui Keary Zhou, Alex Wing Kwan Leung, Chun Kit Ngan, Herbert Ho Fung Loong, Chi Kong Li, Yin Ting Cheung
Name of ConferenceMultinational Association of Supportive Care in Cancer (MASCC)/ Japanese Association of Supportive Care in Cancer (JASCC)/ International Society of Oral Oncology (ISOO) Annual Meeting 2023
Start Date of Conference22/06/2023
End Date of Conference24/06/2023
Place of ConferenceNara
Country/Region of ConferenceJapan
Proceedings TitleSupportive Care in Cancer
Year2023
Month6
Day17
Volume Number31
Issue NumberSuppl. 1
PublisherSpringer
Article numberS399
PagesS97 - S97
LanguagesEnglish-United States
KeywordsCancer-related symptoms, Adolescents and Young Adults, Cancer treatment, Cognitive function
