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Cognitive function and its relationship to other psychosocial factors in lymphoma survivors

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Abstract

Purpose

The purpose of this study was to estimate the prevalence of cognitive disturbance in lymphoma survivors and to explore relationships between cognitive function and other psychosocial factors.

Methods

A package of standardized questionnaires was sent to 622 lymphoma patients treated at the Ottawa Hospital in the preceding 5 years. Patients with central nervous system involvement were excluded. The questionnaires addressed cognitive function, pain, insomnia, fatigue, and mood. Of the patients in the sampling frame, 54 % responded to the survey and 42 % met inclusion/exclusion criteria. Sixteen percent (99/622) agreed to undergo computerized neuropsychological testing with CNS vital signs (CNSVS). Scores on the objective and subjective cognitive measures were compared to those of a healthy female control group from a previous study.

Results

The lymphoma group scored significantly lower than the controls on a cognitive rating scale (p = .018) and on CNSVS (p = .035). The difference on the CNSVS was primarily due to poorer attention and executive function scores in the lymphoma patients. The patients also had a higher frequency of impairment on both the objective (p = .009) and subjective (p < .001) cognitive measures. Among the lymphoma survivors, fatigue and anxiety were related to subjective cognitive disturbance (p < .001 for both), whereas pain was the only psychosocial measure associated with objective cognitive performance (p < .001).

Conclusions

These results suggest that cognitive disturbance may be a significant survivorship issue for lymphoma patients and should be more thoroughly investigated in this population.

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Notes

  1. Scores on the FACT-Cog subscales are also reported in Table 3.

  2. This served to eliminate age differences between the controls and lymphoma patients (see Table 1).

  3. Square root transformations were applied to reaction time and working memory scores to correct for negative skewness in the data but, as this did not substantively alter the results, we report on the analyses with untransformed scores for ease of interpretation.

  4. PIR, ISI, PHQ-9, and GAD-7 scores were all positively skewed; FACT-F was negatively skewed, both in the full lymphoma sample and the subgroup of patients who did the CNSVS. These variables were transformed to correct the distributions but this had no appreciable impact on the outcome of the analyses. For ease of interpretation, we report here on the results obtained using the raw scores.

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Acknowledgements

This research was made possible with financial support from the Hematology Associates at The Ottawa Hospital and the Canadian Breast Cancer Foundation – Ontario Chapter. We would like to thank the many participants in the study, as well as the hematologists and support staff at the Ottawa Hospital who assisted in recruiting participants.

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Authors and Affiliations

  1. The Ottawa Hospital–Civic Campus, 1053 Carling Ave, Room CPC271, Ottawa, ON, K1Y 4E9, Canada

    Dorothy Krolak, Barbara Collins, Lorelle Weiss, Cheryl Harris & Richard Van der Jagt

  2. The Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Dorothy Krolak, Barbara Collins, Lorelle Weiss, Cheryl Harris & Richard Van der Jagt

  3. University of Ottawa, Ottawa, ON, Canada

    Richard Van der Jagt

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  1. Dorothy Krolak
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  2. Barbara Collins
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Correspondence to Barbara Collins.

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All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Statement of originality

This manuscript reports original data. Portions of the data were presented at the annual conference of the Canadian Association of Psychosocial Oncology, Ottawa, Ontario, April 2013. Control group data were included in previous papers published in Psycho-Oncology and Journal of the International Neuropsychological Society. Authors have full control of all primary data and agree to allow the journal to review the data if requested.

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Krolak, D., Collins, B., Weiss, L. et al. Cognitive function and its relationship to other psychosocial factors in lymphoma survivors. Support Care Cancer 25, 905–913 (2017). https://doi.org/10.1007/s00520-016-3480-z

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