Journal of Cancer Research and Clinical Oncology

, Volume 132, Issue 4, pp 234–240

Short-term monitoring of cognitive functions before and during the first course of treatment

  • Barbara Eberhardt
  • Stefan Dilger
  • Frauke Musial
  • Ulrich Wedding
  • Thomas Weiss
  • Wolfgang H. R. Miltner
Original Paper


Purpose: Side effects of chemotherapy on cognitive functions in older patients have rarely been investigated. Addressing this lack of research, the present study evaluated cognitive functions in older cancer patients. Methods: A total of 130 younger (n=59; age<60) and older (n=71; age≥60) cancer patients with hematological disease or cancer of the intestinal tract took part in the study. To explore short-term effects of chemotherapy, a group of patients assessed before the start of chemotherapy was compared with patients who already received their first course of chemotherapy. Results: Cognitive impairments of verbal learning, word fluency, and memory were observed following the first few days after treatment onset. Older patients showed stronger memory impairments after start of chemotherapy than younger cancer patients. Additionally, depression was neither associated with short-term effect of chemotherapy nor with age. Conclusions: The results suggest that chemotherapy has negative short-term effects on some cognitive functions. But age-dependent effects were only found for memory.


Older cancer patients Cognitive impairments Chemotherapy Depression Gender 


  1. Aragona M, Muscatello MRA, Mestiti M (1997) Depressive mood disorders in patients with operable breast cancer. J Exp Clin Cancer Res 16:111–118PubMedGoogle Scholar
  2. Baker SD, Grochow LB (1997) Pharmacology of cancer chemotherapy in the older person. Clin Geriatr Med 13:169–183PubMedGoogle Scholar
  3. Balducci L, Parker M, Sexton WG, Tantranond P (1989) Pharmacology of antineoplastic agents in the elderly patient. Semin Oncol 16:76–84PubMedGoogle Scholar
  4. Brezden CB, Philips KA, Abdolell M, Bunston T, Tannock IF (2000) Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol 18:2695–2701PubMedGoogle Scholar
  5. Bruera E, Miller L, McCallion J, Macmillan K, Krefting L, Hanson J (1992) Cognitive failure in patients with terminal cancer: a prospective study. J Pain Symptom Manage 7:192–195PubMedCrossRefGoogle Scholar
  6. Chibnall JT (2002) Psychosocial–spiritual correlates of death distress in patients with life-threatening medical conditions. Palliat Med 16:331–338PubMedCrossRefGoogle Scholar
  7. Colley A, Ball J, Kirby N, Harvey R, Vingelen I (2002) Gender-linked differences in everyday memory performance: effort makes the difference. Sex Roles 47:577–582CrossRefGoogle Scholar
  8. Cull A (1990) Psychological aspects of cancer and chemotherapy. J Psychosom Res 34:129–140PubMedCrossRefGoogle Scholar
  9. Cull A, Hay C, Love SB, Mackie M, Smets E, Stewart M (1996) What do cancer patients mean when they complain of concentration and memory problems. Br J Cancer 74:1674–1679PubMedGoogle Scholar
  10. Eberhardt B (2003) Neuropsychologische Beeinträchtigungen bei älteren Krebspatienten. Jena, DissertationGoogle Scholar
  11. Eberhardt B, Dilger S, Musial F, Wedding U, Weiss T, Miltner WHR (2005) Medium term effects of chemotherapy in older cancer patients. Support care cancer. On-line at (in press)
  12. Ershler WB, Balducci L (1994) Treatment considerations for older patients with cancer. In vivo 8:737–744PubMedGoogle Scholar
  13. Erzigkeit H (1992) Der SKT. Ein Kurztest zur Erfassung von Gedächtnis- und Aufmerksamkeitsstörungen. Manual 21. Auflage. Weinheim, BeltzGoogle Scholar
  14. Freilich RJ, Delattre JY, Monjour A, DeAngelis LM (1996) Chemotherapy without radiation therapy as initial treatment for primary CNS lymhoma in older patients. Neurology 46:435–439PubMedGoogle Scholar
  15. Gallagher J, Parle M, Cairns D (2002) Appraisal and psychological distress six month after diagnosis of breast cancer. Br J Health Psychol 7:365–376PubMedCrossRefGoogle Scholar
  16. Halpern DF (1992) Sex differences in cognitive abilities, 2nd edn. Lawrence Erlbaum, HillsdaleGoogle Scholar
  17. Hautzinger M, Bailer M, Worall H, Keller F (1995) Beck-depressions-inventar. Bern, HuberGoogle Scholar
  18. Herlitz A, Yonker JE (2002) Sex differences in episodic memory: the influence of intelligence. J Clin Exp Neuropsychol 24:107–114PubMedCrossRefGoogle Scholar
  19. Horn W (1983) Leistungsprüfsystem (LPS): Handanweisung. 2. überarbeitete und verbesserte Auflage. Hogrefe, GöttingenGoogle Scholar
  20. Hyde JS, Linn MC (1988) Gender differences in verbal ability: a meta-analysis. Psychol Bull 104:53–69CrossRefGoogle Scholar
  21. Kessler J, Denzler P, Markowitsch HJ (1999) Demenztest. Eine Testbatterie zur Erfassung kognitiver Beeinträchtigungen im Alter. Beltz Test GmbH, GöttingenGoogle Scholar
  22. Lindenberger U, Baltes PB (1995) Kognitive Leistungsfähigkeit im hohen Alter: Erste Ergebnisse aus der Berliner Altersstudie. Z Psychol 203:283–317PubMedGoogle Scholar
  23. Massie MJ (1990) Depression. In: Holland J, Rowland J (eds) Handbook of psychooncology. Oxford University Press, New York, pp 283–289Google Scholar
  24. Mayer KU, Baltes PB (1999) Die Berliner Altersstudie. Akademie, BerlinGoogle Scholar
  25. Moffic HS, Paykel ES (1975) Depression in medical in-patients. Br J Psychiatry 126:346–353PubMedGoogle Scholar
  26. Monfardini S, Yancick R (1993) Cancer in the elderly: meeting the challenge of an aging population. J Natl Cancer Inst 85:532–538PubMedCrossRefGoogle Scholar
  27. Oxman TE, Silberfarb PM (1980) Serial cognitive testing in cancer patients receiving chemotherapy. Am J Psychiatry 137:1263–1265PubMedGoogle Scholar
  28. Roche RJ, Forman WB, Rhyne RL (1997) Formal geriatric assessment. An imperative for the older person with cancer. Cancer Pract 5:81–86PubMedGoogle Scholar
  29. Rodin G, Voshart K (1986) Depression in the medically ill: an overview. Am J Psychiatry 143:696–705PubMedGoogle Scholar
  30. Schagen SB, van Dam FSAM, Muller MJ, Boogerd W, Lindeboom J, Bruning PF (1999) Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer 85:640–650PubMedCrossRefGoogle Scholar
  31. Schaie KW, Willis SL (1993) Age difference patterns of psychometric intelligence in adulthood: generalizability within and across ability domains. Psychol Aging 8:44–55PubMedCrossRefGoogle Scholar
  32. Schonwetter RS (1992) Geriatric oncology. Prim Care 19:451–463PubMedGoogle Scholar
  33. Sekine I, Fukuda H, Kunitoh H, Saijo N (1998) Cancer chemotherapy in the elderly. Jpn J Clin Oncol 28:463–473PubMedCrossRefGoogle Scholar
  34. Silberfarb PM (1983) Chemotherapy and cognitive defects in cancer patients. Annu Rev Med 34:35–46PubMedCrossRefGoogle Scholar
  35. Silberfarb PM, Oxman TE (1988) The effects of cancer therapies on the central nervous system. Adv Psychosom Med 18:13–25PubMedGoogle Scholar
  36. Smith AB, Selby PJ, Velikova G, Stark D, Wright EP, Gould A, Cull A (2002) Factor analysis of the hospital anxiety and depression scale from a large cancer population. Psychol Psychother 75:165–176PubMedCrossRefGoogle Scholar
  37. Sturm W, Willmes K (1999) Verbaler Lerntest und Nonverbaler Lerntest (VLT/NVLT). Handanweisung. Hogrefe, GöttingenGoogle Scholar
  38. Sturm W, Willmes K, Horn W (1993) Leistungsprüfsystem für 50-90jaehrige (LPS 50+). Hogrefe, GöttingenGoogle Scholar
  39. Taylor BV, Buckner JC, Cascino TL, O`Fallon JR, Schaefer PL, Dinapoli RP, Schomberg P (1998) Effects of radiation and chemotherapy on cognitive function in patients with high-grade glioma. J Clin Oncol 16:2195–2201PubMedGoogle Scholar
  40. Valente SM, Saunders JM (1996) Diagnosis and treatment of major depression among people with cancer. Cancer Nurs 20:168–177CrossRefGoogle Scholar
  41. Valentine AD, Meyers CA, Kling MA, Richelson E, Hauser P (1998) Mood and cognitive side effects of interferon-α therapy. Semin Oncol 25:39–47PubMedGoogle Scholar
  42. Van Dam FSAM, Schagen SB, Muller MJ, Boogerd W, Wall E, Droogleever-Fortuyn ME, Rodenhuis S (1998) Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst 90:210–218PubMedCrossRefGoogle Scholar
  43. Wieneke MH, Dienst ER (1995) Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer. Psychooncology 14:1457–1462Google Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Barbara Eberhardt
    • 1
  • Stefan Dilger
    • 1
  • Frauke Musial
    • 1
  • Ulrich Wedding
    • 2
  • Thomas Weiss
    • 1
  • Wolfgang H. R. Miltner
    • 1
  1. 1.Institute of Psychology, Department of Biological and Clinical PsychologyFriedrich-Schiller-UniversityJenaGermany
  2. 2.Department of Internal MedicineFriedrich-Schiller-UniversityJenaGermany

Personalised recommendations