Longitudinal associations between cancer history and cognitive functioning among older adults |
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| Affiliation: | 1. School of Social Work, University of Alabama, Tuscaloosa, AL 35401, USA;2. Department of Management, University of Alabama, Tuscaloosa, AL 35401, USA;3. School of Social Work, New York University, New York, NY 11220, USA;1. Bruyère Research Institute, Ottawa, Ontario;2. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec;3. Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec;4. Research Centre on Aging, Integrated Academic Health Centre and Social Services in the Eastern Townships, Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Quebec;5. Department of Health Services, University of Washington, Seattle, WA;6. Department of Medicine, McGill University Montreal, Quebec;7. Research Institute of the McGill University Health Centre, Montreal, Quebec;1. Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, No.415 Fengyang Road, Shanghai 200001, China;2. Department of Orthopedic Surgery, Jinling Hospital, Nanjing University, Nanjing, China;3. Department of Orthopedic Surgery, No. 906 Hospital of the People''s Liberation Army, Zhejiang, China;1. Department of Neurology, School of Medicine, Kyungpook National University, Kyungpook National University Chilgok Hospital, Daegu, South Korea;2. Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK;3. Clinical Research Management Team, Ilsan hospital, National Health Insurance Service, Goyang-shi, South Korea;4. Department of Neurology, Dementia Center, Ilsan hospital, National Health Insurance Service, Goyang-shi, South Korea;1. Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan;2. Department of Frailty, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan;3. Department of Public Health, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan;4. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan;5. Department of Orthopedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan;6. Center of Joint Surgery for Rheumatic Diseases and Osteoporosis, Nagoya City East Medical Center, Nagoya, Japan;7. Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan;8. Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu, Japan;9. Department of Social Preventive Medical Sciences, Chiba University, Chiba, Japan;1. Falls, Balance and Injury Research Centre, Neuroscience Research Australia, UNSW, Sydney, NSW, Australia;2. Prince of Wales Clinical School, Medicine, UNSW, Sydney, NSW, Australia;3. School of Public Health and Community Medicine, Medicine, UNSW, Sydney, NSW, Australia;4. Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia;5. Centre for Healthy Brain Ageing, School of Psychiatry, Medicine, University of New South Wales, Sydney, Australia |
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| Abstract: | ObjectivesThis study aimed to examine (1) whether cancer history accelerates older adults’ rates of cognitive decline over time and (2) whether chemotherapy increases older cancer patients’/ survivors’ rates of cognitive decline over time.MethodsThis longitudinal study drew a subsample of 8811 adults aged 65 or older from Wave 6 of the Health and Retirement Study in 2002 and followed biennually until Wave 13 in 2016. Linear mixed-effects models were performed to test whether cancer history and chemotherapy were associated with accelerated rates of cognitive decline over time among older adults in different age groups.ResultsMiddle-old adults (aged 75–84) with a cancer history had significantly reduced rates of cognitive decline over time, including the global measure of cognitive functioning (B = 0.16, p< .01), mental status (B = 0.08, p< .01), and episodic memory (B = 0.09, p< .05) compared to their counterparts without a cancer history. This effect was not significant for the youngest-old (aged 65–74) or oldest-old adults (aged 85 or older). Also, chemotherapy was not significantly associated with older cancer patients’/survivors’ cognitive functioning at baseline or over time in different age groups.ConclusionsThis study finds that cancer history and chemotherapy do not further exacerbate older adults’ cognitive functioning over time. On the contrary, cancer history shows a “protective” effect on middle-old adults’ cognitive functioning. This encouraging finding indicates that older adults can be more actively engaged in the decision-making of treatments and following care plans. Future mediation studies are needed to further investigate underlying mechanisms. |
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