Improving Cognitive Function of Older Adults with a History of Cancer Using Nonpharmacologic Interventions: A Systematic Review

Abstract

Background: Cancer-related cognitive dysfunction (CRCD) refers to changes in cognitive functioning that occurs as a result of cancer treatment including radiation, hormone therapy, surgery, and most often, chemotherapy. While various nonpharmacologic interventions for cognitive impairments have been studied in younger adults with a history of cancer and in older adult populations without cancer, limited information is available regarding nonpharmacologic interventions for older adults with a history of cancer. Purpose: The purpose of this systematic review is to describe the current nonpharmacologic interventions for older adults with CRCD. Data Sources: PubMed, MEDLINE, CINAHL, and Embase. Study Selection: Articles meeting inclusion criteria were appraised by 2 reviewers independently. The Cochrane Risk of Bias Assessment was used to assess study quality. Data Extraction: The search located 3441 articles; 4 met inclusion criteria. Data Synthesis: Nonpharmacologic interventions addressed the cognitive processes of executive function (n = 2), attention (n = 1), learning/memory (n = 2), perceptual-motor (n = 1), and global cognitive function (n = 3). Two studies used exercise-based interventions and 2 employed cognitive training interventions to address CRCD. Discussion and Limitations: Although improvements in CRCD were found, the interventions used and measure type suggested a high degree of variability challenging the ability to make recommendations for the use of these nonpharmacologic interventions without completion of further studies. Conclusions: As promising evidence has been reported of the effect of aerobic exercise and cognitive training interventions on CRCD in both young survivors of cancer and older adults without cancer, further study is needed to replicate those benefits in older adults with CRCD.