Echoes of the struggle with cancer: cognitive impairment in Chinese children

Cancer-related cognitive impairment is a common complication among pediatric cancer patients, significantly hindering their return to school and family life. However, research on cancer-related cognitive impairment is still insufficient in China. This study aimed to investigate the prevalence and independent predictors of cancer-related cognitive impairment in pediatric cancer patients.

Through convenience sampling, a multicenter cross-sectional survey was conducted in four hospitals in western, northern, and central China from September 2023 to August 2024. A total of 276 pediatric cancer patients aged 6 to 16 years old were recruited. Data was collected using a general information questionnaire, the Wechsler Intelligence Scale for Children-Fourth Edition Chinese Version (short form), the Spence Children's Anxiety Scale-Short Version, and the sleep disturbances scale for children. Binary logistic regression analysis was performed to identify independent predictors of cognitive impairment and the results were visualized using a forest plot.

The Wechsler Intelligence Scale score of pediatric cancer patients was 93.85 ± 9.46, with cancer-related cognitive impairment prevalence rate of 34.1%. Binary logistic regression identified several independent predictors: sleep disorders (OR = 2.85, 95% CI: 1.38-5.86), parenting style (OR = 3.24, 95% CI: 1.46-7.18), father's educational level (OR = 0.10, 95% CI: 0.02-0.40), personality trait (OR = 2.71, 95% CI: 1.31-5.62), age at initial diagnosis (OR = 0.33, 95% CI: 0.17-0.65), number of chemotherapy sessions (OR = 3.42, 95% CI: 1.71-6.84), and anxiety (OR = 2.51, 95% CI: 1.09-5.78).

Pediatric cancer patients exhibit lower cognitive function, influenced by a combination of sleep quality, family environment, age at diagnosis, anti-cancer treatment, and psychological factors. Clinical healthcare providers should accurately assess and identify cognitive impairments in these children and develop personalized intervention strategies based on their individual health status and influencing factors to enhance their cognitive abilities and improve their quality of life.