Associations of functional, psychosocial, medical, and socio-demographic factors with cognitive screening in chemotherapy naïve patients with breast cancer

Abstract

Objective: To describe associations of functional, psychosocial, medical, and socio-demographic factors with performance on a cognitive screening test in chemotherapy naïve patients with breast cancer. Methods: Women with breast cancer were recruited between 2009 and 2018. The Blessed Orientation Memory Concentration Test (BOMC) was administered prior to chemotherapy. Associations between baseline BOMC and functional (Karnofsky Self-Reported Performance Rating Scale (KPS), Time Up and Go Test (TUG), Medical Outcomes Study (MOS) Physical Function, Instrumental Activities of Daily Living (IADL)), psychosocial (Mental Health Inventory-13, MOS Social Activity Limitation and Social Support Survey), medical, and socio-demographic variables were assessed using linear regression analysis. Results: In a sample of 331 women with breast cancer, the mean age was 65.2 years and 68.6% were 65 and older. Mean BOMC score was 3.60 on a scale from 0 (best) to 28 (worst). After controlling for demographic factors, worse BOMC screening test results were associated with KPS < 80 (P = 0.01), IADL<14 (P = 0.02), TUG ≥14 seconds (P = 0.001), worse MOS Physical Function (P = 0.0006), depressive symptoms (P = 0.04), and social activity limitations (P = 0.01). Conclusion: In a sample of women with breast cancer, pre-treatment cognitive screening scores did not reveal profound cognitive impairment. BOMC screening scores were associated with multiple measures of physical function, but further research is needed to determine a clinically meaningful cut point in the BOMC for screening of cancer-related cognitive impairment.