Wake Forest University, School of Medicine, Winston-Salem, NC
Abigail Gifford , Julia Lawrence , Doug Case , Steve Rapp , Laura Baker , Suzanne Craft , David L. Groteluschen , Heidi Klepin , Glenn Lesser , Michelle Joy Naughton , Bonnie Sachs , Thomas A. Samuel , Kaycee Sink , Jeff Williamson , Edward G. Shaw
Background: This abstract uses the National Institute on Aging/Alzheimer’s (NIA/AA) criteria to report the prevalence of MCI in a cohort of breast cancer survivors who received adjuvant chemotherapy. Methods: Wake Forest NCORP Research Base prospective clinical trial 97211 enrolled 62 breast cancer survivors 1-5 year post adjuvant chemotherapy between 7/12-1/13 to test the efficacy of donepezil on cognitive function. Subjective cognitive complaints were evaluated with the Functional Assessment of Cancer Therapy-Cognition. Objective cognitive performance was assessed using standardized/validated neurocognitive measures. Functional status was evaluated with the FACIT-Fatigue. The NIA/AA MCI criteria as applied to this study were: 1) self-reported cognitive complaints (FACT-Cog score < 63), 2) significant cognitive impairment ( ≥ 1.5 SD below the normative mean) in ≥ 1 cognitive domains, 3) preservation of functional independence, and 4) not demented. MCI was further classified as amnestic/non-amnestic and single-/multi-domain. Results: Sixty women between the ages of 39 and 79 completed the objective cognitive battery. At baseline, 80% demonstrated significant cognitive impairment. 58% met the NIA/AA criteria for MCI (of those, 26% were amnestic/multi-domain, 9% amnestic/single-domain, 17% non-amnestic/multi domain, 49% non-amnestic single domain MCI). 22% had significant cognitive impairment with loss of functional independence. Conclusions: In this cohort, 58% met the accepted NIA/AA criteria for MCI. The American Heart and Stroke Associations have adopted these criteria to define Vascular Cognitive Impairment (VCI), vascular MCI (vMCI), and Vascular Dementia (VaD). Similarly, standard criteria to characterize cognitive dysfunction should be applied in the cancer setting. We propose implementing the terms Cancer Cognitive Impairment (CCI), cancer MCI (cMCI), and Cancer Dementia (CaD) to describe the spectrum of cancer- and cancer-treatment associated cognitive impairment.
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