Symptom distress and treatment interest for cognitive decline in neuro-oncology

Adult patients with brain tumors experience cognitive, physical, and emotional sequelae from the disease and treatment. Cognitive changes, in particular, are a common source of distress and can be treated using varied approaches. Establishing the relationship between sources of distress and understanding patient preferences for treatment of cognitive change is necessary for future integrative neurocognitive programmatic development.

Neuro-oncology patients (primary and metastatic) reported their distress related to common neuro-oncology disease symptoms, treatment preferences for cognitive change (e.g., cognitive rehabilitation, mindfulness training, psychotherapy, medication), and a measure of subjective cognition. Demographics and tumor characteristics were self-reported. Descriptive statistics, correlations, and t-tests were conducted.

One hundred thirty-seven patients (M _age = 49.6 ± 15.8, 58.1% female, 84.8% White) participated. Cognitive change was the most frequently endorsed source of distress (74.1%), followed by fatigue (68.4%) and mood changes (58.5%). Distress due to cognitive changes was rated significantly higher than all other symptoms (Ps < .05) except for fatigue and did not vary based on demographics or disease characteristics (Ps > .05). To address cognitive concerns, patients were most interested in cognitive rehabilitation (63.6%), mindfulness (61.6%), and psychotherapy (56.6%). They were least interested in medication (40.4%).

Neuro-oncology patients reported distress due to cognitive changes more frequently than distress due to other disease sequelae (e.g., mood changes, physical symptoms), and this was robust across patient demographics and disease characteristics. Patients reported high interest in cognitive rehabilitation, mindfulness training, and psychotherapy for management of cognitive concerns, suggesting the need for non-pharmacological multi-modal interventions.