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Initial encoding deficits with intact memory retention in older long-term breast cancer survivors

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Abstract

Purpose

Cancer survivors frequently report significant forgetfulness, but standard neuropsychological tests often fail to detect primary memory deficits. Past research has suggested survivors may misattribute forgetfulness to memory decay rather than impairments in initial encoding, but no studies have tested whether this pattern is evident in older survivors, who are more vulnerable to age-related memory difficulties. We examined whether long-term breast cancer survivors treated in older adulthood demonstrate deficits in initial encoding, as opposed to increased rates of memory decay, relative to non-cancer controls.

Methods

Three hundred twenty-eight breast cancer survivors age 60 and above, 5–15 years post-treatment, and 162 age-matched non-cancer controls completed list learning and narrative memory assessments at four time-points over 2 years. Performance on learning trials and delayed recall was analyzed at each time-point to assess group differences in memory encoding, and memory decay was assessed by analyzing changes in performance across delays.

Results

Univariate ANCOVAs correcting for age and education showed that survivors had worse initial encoding performance across multiple time-points, which were compensated for with multiple learning trials to produce recall performance comparable to controls. There were no significant group differences in memory decay.

Conclusions

Older long-term breast cancer survivors exhibit a consistent pattern of initial encoding deficits, but memory retention was comparable to controls. Future research should consider the role of encoding deficits and age-related factors when evaluating cognitive function in older survivors.

Implications for Cancer Survivors

Commonly reported memory problems may stem from encoding deficits in older long-term cancer survivors.

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Availability of data and materials

The data underlying this article will be shared on reasonable request to the corresponding author.

Code availability

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Acknowledgements

The authors want to acknowledge Dr. Arti Hurria for her role in the development and conceptualization of this project.

Funding

This work was supported by grants from the National Cancer Institute at the National Institutes of Health (R01 CA172119, U54 CA137788, P30 CA008748, and T32 CA009461).

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Ave, 7th Floor, New York, NY, USA

    Alexandra M. Gaynor, Tim A. Ahles, Elizabeth Ryan, Elizabeth Schofield, Yuelin Li, Katrazyna McNeal & James C. Root

  2. Departments of Population Science and Supportive Care Medicine, City of Hope Comprehensive Cancer Center, Duarte, CA, USA

    Sunita K. Patel

  3. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Tiffany Traina

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  1. Alexandra M. Gaynor
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  2. Tim A. Ahles
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Contributions

AMG: data curation, formal analysis, writing—original draft, writing—review and editing, and visualization. TAA: conceptualization, funding acquisition, investigation, writing—review and editing. ER: resources, writing—review and editing. LS: formal analysis, writing—review and editing. YL: formal analysis, writing—review and editing. SKP: resources, investigation, data curation, writing—review and editing. KM: investigation, data curation, and writing—review and editing. TT: resources, writing—review and editing. JCR: conceptualization, resources, investigation, writing—review and editing. AH: conceptualization, funding acquisition, and investigation. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Alexandra M. Gaynor.

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Ethics approval

This study involving human participants was performed in accordance with the ethical standards of the institution and national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The study protocol was approved by the ethics committee and the Institutional Review Boards at Memorial Sloan Kettering Cancer Center and City of Hope National Medical Center.

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Informed consent was obtained from all participants in this study.

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Not applicable.

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All authors have confirmed that they have no conflicts of interest to disclose.

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Gaynor, A.M., Ahles, T.A., Ryan, E. et al. Initial encoding deficits with intact memory retention in older long-term breast cancer survivors. J Cancer Surviv 16, 940–947 (2022). https://doi.org/10.1007/s11764-021-01086-8

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