Cognitive function is well preserved in a cohort of breast cancer survivors: Roles of cognitive reserve,resilience, and general health

Many patients return to cognitively demanding work after breast cancer treatments. This makes treatment-related cognitive decline an important research topic. Psychological resilience, cognitive reserve and better perceived general health may work as protective factors against cognitive decline. The aim of this study was to analyse whether these factors are associated with cognitive function among such women.Data from 384 breast cancer survivors who underwent neuropsychological examination at follow-up 4–9 years after surgery were used. The neurocognitive domain variable Learning and Memory was computed from Wechsler Memory Scale-III subtests Learning and Delayed Recall. Another variable, Attention, Processing speed and Executive function, was computed from semantic and verbal fluency tests, Trail Making Test A and B, and Wechsler Adult Intelligence Test-IV subtest Coding. Psychological resilience was measured with Resilience Scale-14, and perceived general health with RAND-36 subitem General Health.Resultsshowed that levels of cognitive performance and general health were statistically higher than population average. Resilience and general health in separate models were associated with Attention, Processing speed and Executive function (β = 0.14, p = 0.01; β = 0.13, p = 0.03, respectively). When added simultaneously in the same model, resilience was significant (β = 0.13, p = 0.04), but general health was not. These associations were nonsignificant after controlling for confounding factors. Learning and Memory was not associated with resilience or general health.Future research should focus on longitudinal studies identifying patients at a high risk of developing cognitive decline after breast cancer treatments and on preventive and therapeutic approaches.