The effects of physical activity and fatigue on cognitive performance in breast cancer survivors
- 946 Downloads
Research suggests that physical activity may be a promising treatment for cancer-related cognitive impairment; however, evidence is limited by small samples and self-report measures and little is known about the underlying mechanisms. The purpose of this study was to examine the effects of physical activity on cognitive function in a national sample of breast cancer survivors (BCSs) using objective measures. We hypothesized that physical activity’s effects on cognition would be indirect through survivors’ self-reported fatigue.
Participants (N = 299; M = 57.51 ± 9.54 years) included BCSs with access to an iPad. Participants wore an accelerometer for seven consecutive days to measure their average daily minutes of moderate-to-vigorous physical activity (MVPA) and completed a battery of questionnaires and neuropsychological tests via an iPad application to measure fatigue and cognitive function. Cognitive function was modeled as two latent factors—executive function and working memory—comprising performance across seven cognitive tasks. A structural equation modeling framework was used to test the hypotheses.
MVPA was associated with less fatigue (γ = 0.19), which, in turn, was associated with faster times on executive function tasks (γ = −0.18) and greater accuracy on working memory tasks (γ = 0.16). The indirect paths from MVPA to cognitive performance were also significant (executive function: β = −0.03, memory: β = 0.03).
Findings suggest that MVPA may be associated with greater executive function and working memory in BCSs. Further, this effect may be partially indirect through cancer-related symptoms (e.g., fatigue). Results emphasize the need for additional scientific investigation in the context of prospective and efficacy trials.
KeywordsCancer-related cognitive impairment Physical activity Fatigue Breast cancer
The authors would like to acknowledge Allen Best and the Team at Digital Artefacts for their development of the iPad application used for this study.
Compliance with ethical standards
Conflicts of interest
DKE is supported by an American Cancer Society Postdoctoral Fellowship (PF-16-021-01-CPPB).
This study was approved by and carried out in accordance with the recommendations of the Institutional Review Board at the University of Illinois at Urbana-Champaign with signed informed consent from all participants. The study is registered with United States National Institutes of Health http://ClinicalTrials.gov (ID NCT02523677).
- 3.Argyriou AA, Assimakopoulos K, Iconomou G, Giannakopoulou F, Kalofonos HP (2011) Either called “chemobrain” or “chemofog,” the long-term chemotherapy-induced cognitive decline in cancer survivors is real. J Pain Symptom Manag 41(1):126–139. doi: 10.1016/j.jpainsymman.2010.04.021 CrossRefGoogle Scholar
- 8.Mackenzie M, Zuniga K, McAuley E (2006) Cognitive impairment in breast cancer: the protective role of physical activity, cardiorespiratory fitness, and exercise training. In: McMorris T (ed) Exercise-cognition interaction: neuroscience perspectives. Elsevier, AmsterdamGoogle Scholar
- 16.Northey JM, Cherbuin N, Pumpa KL, Smee DJ, Rattray B, Northey JM (2017) Exercise interventions for cognitive function in adults older than 50: a systematic review with meta-analysis. (3):1–9. doi: 10.1136/bjsports-2016-096587
- 25.Mishra SI, Scherer RW, Snyder C, Geigle PM, Berlanstein DR, Topaloglu O (2015) Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev (8). www.cochranelibrary.com
- 31.Goodman RA, Posner SF, Huang ES, Parekh AK, Koh HK (2013) Defining and measuring chronic conditions: imperatives for research, policy, program, and practice. 10. doi: 10.5888/pcd10.120239
- 37.Battery AIT (1994) Manual of directions and scoring. War Department, Adjutant General’s Office, Washington, DCGoogle Scholar
- 42.Crowgey T, Peters KB, Hornsby WE et al (2013) Relationship between exercise behavior, cardiorespiratory fitness, and cognitive function in early breast cancer patients treated with doxorubicin-containing chemotherapy: a pilot study 1. Appl Physiol Nutr Metab 39(December):724–729PubMedPubMedCentralGoogle Scholar
- 46.Kesler S, Janelsins M, Koovakkattu D et al (2013) Reduced hippocampal volume and verbal memory performance associated with interleukin-6 and tumor necrosis factor-alpha levels in chemotherapy-treated breast cancer survivors. Brain Behav Immun 30(Suppl.):S109–S116. doi: 10.1016/j.bbi.2012.05.017 CrossRefPubMedGoogle Scholar
- 49.Lynch BM, Dunstan DW, Healy GN, Winkler E, Eakin E, Owen N (2010) Objectively measured physical activity and sedentary time of breast cancer survivors, and associations with adiposity: findings from NHANES (2003–2006). Cancer Causes Control 21(2):283–288. doi: 10.1007/s10552-009-9460-6 CrossRefPubMedGoogle Scholar
- 50.Bluethmann SM, Mariotto AB, Rowland JH. Anticipating the “Silver Tsunami”: prevalence trajectories and comorbidity burden among older cancer survivors in the United States. Cancer Epidemiol Biomark Prev 25(7). doi: 10.1158/1055-9965.EPI-16-0133