Keywords

Breast cancer survivor, Cardiovascular disease, Cognitive dysfunction, Neuropsychological assessment, Symptoms

 

Authors

  1. Von Ah, Diane PhD, RN
  2. Crouch, Adele PhD, RN, AGCNS-BC
  3. Arthur, Elizabeth PhD, APRN-CNP, AOCNP
  4. Yang, Yesol PhD, NP-C
  5. Nolan, Timiya PhD, APRN-CNP, ANP-BC

Abstract

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.