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Cognitive rehabilitation for cancer-related cognitive dysfunction: a systematic review

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Abstract

Purpose

Individuals with non-central nervous system (CNS) cancers can experience cancer-related cognitive dysfunction (CRCD), negatively impacting daily functioning and quality of life. This systematic review examined cognitive rehabilitation programs aimed at improving cognitive function.

Methods

PsychInfo and PubMed were searched in February 2019. Eligible studies evaluated a cognitive rehabilitation program for adults with non-CNS cancers and included at least one objective cognitive measure. Across studies, we assessed methodological quality using relevant criteria based on published intervention-related review guidelines and examined findings from performance-based and self-reported outcome measures.

Results

19 studies met inclusion criteria, totalling 1124 participants altogether. These studies included randomized controlled trials (n = 12), partial, quasi or non-randomized controlled trials (n = 3) and single-arm pilot studies (n = 4). All studies found improvements on at least one cognitive measure (performance-based or self-reported). By cognitive domain, objective improvements in memory were most commonly reported, followed by executive functions and processing speed. In terms of methodological quality, studies generally provided clear descriptions of participants and interventions. However, limitations included lack of standardized terminology for interventions, discrepancies in outcome measures, and incomplete statistical reporting.

Conclusions

The available evidence supports clinical implementation of cognitive rehabilitation to improve CRCD, with further work in program development, dissemination, and feasibility recommended. We provide specific recommendations to facilitate future research and integration in this field.

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Acknowledgments

This work was supported in part by the Princess Margaret Cancer Foundation and the Ontario Ministry of Health and Long Term Care.

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Author notes

  1. Nadine M. Richard and Kim Edelstein share senior authorship.

Authors and Affiliations

  1. Department of Psychology, Faculty of Health, York University, 4700 Keele St., Toronto, ON, M3J 1P3, Canada

    Holly A. Fernandes

  2. Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada

    Nadine M. Richard & Kim Edelstein

  3. Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Kim Edelstein

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  1. Holly A. Fernandes
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Correspondence to Holly A. Fernandes.

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Fernandes, H.A., Richard, N.M. & Edelstein, K. Cognitive rehabilitation for cancer-related cognitive dysfunction: a systematic review. Support Care Cancer 27, 3253–3279 (2019). https://doi.org/10.1007/s00520-019-04866-2

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