Cognitive Trajectories in Older Patients with Cancer Undergoing Radiotherapy—A Prospective Observational Study
Eriksen, Guro Falk; Saltyte Benth, Jurate; Grønberg, Bjørn Henning; Rostoft, Siri; Kirkevold, Øyvind; Bergh, Sverre; Hjelstuen, Anne Kristine; Rolfson, Darryl; Jordhøy, Marit Slaaen
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2022Metadata
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Eriksen, G. F., Šaltytė Benth, J., Grønberg, B. H., Rostoft, S., Kirkevold, Ø., Bergh, S., Hjelstuen, A., et al. (2022). Cognitive Trajectories in Older Patients with Cancer Undergoing Radiotherapy—A Prospective Observational Study. Current Oncology, 29(7), 5164–5178. MDPI AG. Retrieved from http://dx.doi.org/10.3390/curroncol29070409 10.3390/curroncol29070409Abstract
Cognitive function can be affected by cancer and/or its treatment, and older patients are
at a particular risk. In a prospective observational study including patients 65 years referred for
radiotherapy (RT), we aimed to investigate the association between patient- and cancer-related factors
and cognitive function, as evaluated by the Montreal Cognitive Assessment (MoCA), and sought
to identify groups with distinct MoCA trajectories. The MoCA was performed at baseline (T0), RT
completion (T1), and 8 (T2) and 16 (T3) weeks later, with scores ranging between 0 and 30 and higher
scores indicating better function. Linear regression and growth mixture models were estimated to
assess associations and to identify groups with distinct MoCA trajectories, respectively. Among
298 patients with a mean age of 73.6 years (SD 6.3), the baseline mean MoCA score was 24.0 (SD 3.7).
Compared to Norwegian norm data, 37.9% had cognitive impairment. Compromised cognition was
independently associated with older age, lower education, and physical impairments. Four groups
with distinct trajectories were identified: the very poor (6.4%), poor (8.1%), fair (37.9%), and good
(47.7%) groups. The MoCA trajectories were mainly stable. We conclude that cognitive impairment
was frequent but, for most patients, was not affected by RT. For older patients with cancer, and in
particular for those with physical impairments, we recommend an assessment of cognitive function.