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Assessing cognitive function in cancer patients

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Abstract

Goals of work

Some patients with cancer suffer cognitive impairment after chemotherapy. A brief, sensitive instrument is required to screen patients for cognitive impairment. In this study, we compare three possible screening instruments.

Materials and methods

Cancer patients (n=31) who had received adjuvant chemotherapy within 2 years underwent cognitive evaluation on three occasions. Fluent English speakers (n=20) completed the High Sensitivity Cognitive Screen (HSCS), the computer-based Headminder and CogHealth, and the Functional Assessment of Cancer Therapy-cognitive function (FACT-COG) questionnaire. Patients not fluent in English (NESB) (n=11) performed CogHealth and Headminder.

Results

The patients were aged 31–65 years, and 94% were women with breast cancer. At baseline, 6 of 20 (30%) had moderate–severe cognitive impairment on HSCS, 17 of 31 (55%) had scores greater than one standard deviation (SD) below the mean for normative data in one to two of three domains on Headminder, and on CogHealth, 8 of 31 (26%) were greater than one SD below the mean in at least two of six domains. A large practice effect was seen for the HSCS, with moderate–severe cognitive impairment decreasing from 30 to 5% between the first and second assessment. On FACT-COG, 9 of 19 patients (47%) rated their cognition as greater than one SD below that of a pre-chemotherapy breast cancer control group, with impact on quality of life greater than one SD below for 10 of 19 (53%) patients. No correlation was seen between objective cognitive testing and the FACT-COG.

Conclusions

CogHealth and Headminder were suitable for NESB patients. The HSCS is not recommended for longitudinal studies with short intervals between testing due to practice effect. There is poor correlation between the patients’ perception of their cognitive impairment and the objective tests.

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Authors and Affiliations

  1. Princess Margaret Hospital, University of Toronto, 610 University Ave, Toronto, M5G 2M9, ON, Canada

    Janette Vardy, Karen Wong, Qi-long Yi, Alison Park & Ian F. Tannock

  2. CogState Limited, Level 7, 21 Victoria St, Melbourne, Victoria, 3000, Australia

    Paul Maruff

  3. Evanston Northwestern Healthcare, Northwestern University Medical School, 2650 Ridge Ave, Evanston, IL, 60201, USA

    Lynne Wagner

  4. Department of Medical Oncology and Hematology, Princess Margaret Hospital, 610 University Avenue, Toronto, M5G 2M9, ON, Canada

    Janette Vardy

Authors
  1. Janette Vardy
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  2. Karen Wong
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  3. Qi-long Yi
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  4. Alison Park
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  5. Paul Maruff
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  6. Lynne Wagner
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  7. Ian F. Tannock
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Correspondence to Janette Vardy.

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Vardy, J., Wong, K., Yi, Ql. et al. Assessing cognitive function in cancer patients. Support Care Cancer 14, 1111–1118 (2006). https://doi.org/10.1007/s00520-006-0037-6

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  • DOI: https://doi.org/10.1007/s00520-006-0037-6

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