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Association Between Cardiovascular Disease and Cognitive Dysfunction in Breast Cancer Survivors
Diane Von Ah1, Adele Crouch, Elizabeth Arthur
1Author Affiliations: College of Nursing, The Ohio State University, Columbus (Drs Von Ah and Nolan); NewCourtland Center for Transitions and Health, University of Pennsylvania School of Nursing, Philadelphia (Dr Crouch); and The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus (Drs Arthur and Yang).
Insights
Breast cancer survivors with cardiovascular disease face higher risks of cognitive dysfunction. This highlights the critical link between cancer treatment, heart health, and brain function in survivors.
Area of Science:
- Oncology
- Cardiology
- Neuroscience
Background:
- Breast cancer survivors (BCSs) are at increased risk for cardiovascular disease (CVD), including heart failure and hypertension.
- CVD can exacerbate cognitive dysfunction, a common and debilitating symptom in BCSs.
Purpose of the Study:
- To investigate the association between cardiovascular disease and cognitive function in breast cancer survivors.
- To understand how conditions like heart failure and hypertension impact cognitive performance in this population.
Main Methods:
- Analysis of baseline data from a cognitive training trial involving early-stage BCSs.
- Participants completed neuropsychological assessments measuring memory, attention, processing speed, and verbal fluency.
- Statistical methods included descriptive statistics, correlation, and linear regression.
Main Results:
- Cardiovascular disease was present in 44.7% of the 47 studied BCSs.
- CVD was significantly associated with poorer performance in immediate and delayed memory and attention/working memory (P < .01-.05).
Conclusions:
- BCSs with co-occurring cardiovascular disease may experience greater cognitive dysfunction post-treatment.
- This research underscores the interplay between cancer, cardiotoxicity, and cognition, informing clinical practice and future studies.
Background:
Breast cancer survivors (BCSs) may have a greater risk for cardiovascular disease (congestive heart failure and hypertension), which in turn, can affect cognitive dysfunction, a frequent, bothersome, and potentially debilitating symptom.
Objective:
The purpose of this study was to examine the relationship of cardiovascular disease on cognitive function in BCSs.
Methods:
Baseline data from a double-blind randomized controlled trial for cognitive training of BCSs were examined. Early-stage BCS (stages I-IIIA) who were 21 years or older, completed adjuvant therapy (≥6 months), and reported cognitive concerns completed questionnaires and a brief neuropsychological assessment, including tests of memory, attention and working memory, speed of processing, and verbal fluency. Descriptive statistics, Pearson correlation coefficient, and separate linear regression models for each cognitive domain were conducted.
Results:
Forty-seven BCSs, who were on average 57.3 (SD, 8.1) years old, were 58% White, and had some college education (75%), completed the study. Furthermore, 44.7% of the BCS had cardiovascular disease (congestive heart failure or hypertension). In linear regression models, cardiovascular disease was significantly related to immediate and delayed memory and attention and working memory ( P < .01-.05).
Conclusion:
Breast cancer survivors who have cardiovascular disease may also be at a greater risk for cognitive dysfunction post treatment. Results from this study inform both clinical practice and future research, specifically by examining the intersection between cancer, cardiovascular disease (cardiotoxicity), and cognition.
Implications For Practice:
Nurses should be aware that BCSs with co-occurring cardiovascular disease are at a higher risk for cognitive dysfunction and work within the multidisciplinary team to optimize BCS health and function.
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