Prevalence of self-reported memory problems in adult cancer survivors: a national cross-sectional study.

PURPOSE Cancer and its treatments can impair cognitive function, especially memory, leading to diminished quality of life. Prevalence studies of cancer treatment-related memory impairment have not been conducted in the adult-onset cancer population. METHODS To determine the prevalence of self-reported memory (SRM) problems in people with and without a history of cancer, we analyzed data from a large, nationally representative sample of the civilian, noninstitutionalized US population. Participants answered the yes-or-no question, "Are you limited in any way because of difficulty remembering or because you experience periods of confusion?" Age, sex, race/ethnicity, education, poverty, and general health were controlled. RESULTS The sample (N = 9,819) consisted of 4,862 men and 4,957 women age 40 years and older. There were 1,938 blacks, 5,552 whites, 1,998 Hispanics, and 331 participants categorized as other race/multiracial. Of these, 1,305 reported a history of cancer; 8,514 did not. Memory problems were self-reported more often by participants with a history of cancer (14%) than by those without (8%). Having had cancer was independently associated with SRM impairment (adjusted odds ratio, 1.4; 95% CI, 1.08 to 1.83). Other predictors of memory impairment were age, lower education, lower income, and poorer general health (P < .01 for all). Participants with cancer had a 40% greater likelihood of reporting memory problems relative to those without cancer. CONCLUSION Cancer history independently predicted SRM impairment. Prevalence of SRM impairment in people with a history of cancer/cancer treatment is substantial and increasing. Health care providers should assess and be ready to treat memory impairment in patients with a history of cancer.

[1]  J. Rowland Cancer survivorship: rethinking the cancer control continuum. , 2008, Seminars in oncology nursing.

[2]  Andrew J Saykin,et al.  Neuropsychologic impact of standard-dose systemic chemotherapy in long-term survivors of breast cancer and lymphoma. , 2002, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  Andrew J Saykin,et al.  Mechanisms of chemotherapy-induced cognitive disorders: neuropsychological, pathophysiological, and neuroimaging perspectives. , 2003, Seminars in clinical neuropsychiatry.

[4]  B. Stewart,et al.  World Cancer Report , 2003 .

[5]  M Abdolell,et al.  Cognitive function in breast cancer patients receiving adjuvant chemotherapy. , 2000, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  M. Wieneke,et al.  Neuropsychological assessment of cognitive functioning following chemotherapy for breast cancer , 1995 .

[7]  C. Bender,et al.  Cognitive dysfunction following adjuvant chemotherapy for breast cancer: two case studies. , 2003, Oncology nursing forum.

[8]  M. Muller,et al.  Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma , 1999, Cancer.

[9]  Andrew J Saykin,et al.  Mild cognitive impairment: conceptual issues and structural and functional brain correlates. , 2003, Seminars in clinical neuropsychiatry.

[10]  H. Cohen,et al.  Report of the national institute on aging task force on comorbidity. , 2007, The journals of gerontology. Series A, Biological sciences and medical sciences.

[11]  S. Pal,et al.  Evaluating the Older Patient with Cancer: Understanding Frailty and the Geriatric Assessment , 2010, CA: a cancer journal for clinicians.

[12]  J. Samet,et al.  Determinants of cancer therapy in elderly patients , 1993 .

[13]  R. Theriault,et al.  ‘Chemobrain’ in breast carcinoma? , 2004, Cancer.

[14]  Jacqueline Dunbar-Jacob,et al.  The impact of cognitive function on medication management: three studies. , 2010, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[15]  S. Rodenhuis,et al.  Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. , 1998, Journal of the National Cancer Institute.

[16]  I. Tannock,et al.  Cognitive function, fatigue, and menopausal symptoms in women receiving adjuvant chemotherapy for breast cancer. , 2003, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[17]  A. Jemal,et al.  Cancer Statistics, 2009 , 2009, CA: a cancer journal for clinicians.

[18]  Ian F Tannock,et al.  Cognitive impairment associated with chemotherapy for cancer: report of a workshop. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[19]  S. Lipshultz,et al.  Cardiotoxicity after childhood cancer: beginning with the end in mind. , 2010, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[20]  Paul Maruff,et al.  The nature and severity of cognitive impairment associated with adjuvant chemotherapy in women with breast cancer: A meta-analysis of the current literature , 2005, Brain and Cognition.