Prospective Evaluation of Pretreatment Executive Cognitive Impairment and Depression in Patients Referred for Radiotherapy

Published on Oct 1, 2008in International Journal of Radiation Oncology Biology Physics7.038
· DOI :10.1016/J.IJROBP.2007.12.040
Clifton D. Fuller53
Estimated H-index: 53
 (OHSU: Oregon Health & Science University), Jason E. Schillerstrom9
Estimated H-index: 9
 (University of Texas Health Science Center at San Antonio)+ 3 AuthorsMartin Fuss17
Estimated H-index: 17
 (OHSU: Oregon Health & Science University)
Sources
Abstract
Purpose: Cancer patients are at risk of cognitive impairment and depression. We sought to ascertain the prevalence of executive, visuospatial, memory, and general cognitive performance deficits before radiotherapy in a radiation oncology clinic referral population and correlate the neurocognitive measures with the depression symptom burden. Methods and Materials: A total of 122 sequential patients referred for radiotherapy evaluation were administered a test battery composed of the Executive Interview (EXIT25), Executive Clock Drawing Task (CLOX1 and CLOX2), Mini Mental State Examination (MMSE), Memory Impairment Screen (MIS), and Geriatric Depression Scale (GDS). The mean age {+-} standard deviation was 58 {+-} 17 years. Of 122 patients, 24 (20%) had been referred for breast cancer, 21 (17%) for gastrointestinal cancer, 17 (14%) for genitourinary disease, and 8 (7%) for brain lesions; the rest were a variety of tumor sites. The cognitive performance among the tumor cohorts was compared using Bonferroni-corrected analysis of variance and Tukey-Kramer tests. Pearson correlation coefficients were determined between each cognitive instrument and the GDS. Results: Of the 122 patients, 52 (43%) exhibited a detectable executive cognition decrement on one or more test measures. Five percent had poor memory performance (MIS), 18% had poor visuospatial performance (CLOX2), and 13% hadmore » poor global cognition (MMSE). Patients with brain tumors performed substantially worse on the EXIT25. No between-group differences were found for CLOX1, CLOX2, MIS, or GDS performance. The EXIT25 scores correlated significantly with the GDS scores (r = 0.26, p = 0.005). Conclusions: The results of this study have shown that patients referred for radiotherapy exhibit cognitive impairment profiles comparable to those observed in acutely ill medical inpatients. Executive control impairment appears more prevalent than global cognitive deficits, visuospatial impairment, or depression.« less
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References29
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Jul 1, 2007·Journal of Neuropsychiatry and Clinical Neurosciences2.20
#1Donald R. Royall (University of Texas Health Science Center at San Antonio)H-Index: 51
#2Edward C. Lauterbach (Mercer University)H-Index: 28
Last. Kevin J. Black (WashU: Washington University in St. Louis)H-Index: 39
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This report reviews the state of the literature and opportunities for research related to the cognitive correlates of functional status. The prediction of functional capacity on the basis of cognitive test performance is an important aspect of neuropsychological assessment. Moreover, functional impairment or "disability" is an essential part of dementia case finding. Nevertheless, relatively little attention has been given to the empirical study of the specific cognitive correlates of functional...
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Feb 1, 2007·American Journal of Geriatric Psychiatry4.11
#1Jason E. Schillerstrom (University of Texas Health Science Center at San Antonio)H-Index: 9
#2Denae Rickenbacker (University of Texas Health Science Center at San Antonio)H-Index: 1
Last. Donald R. Royall (University of Texas Health Science Center at San Antonio)H-Index: 51
view all 4 authors...
Objective This study measured the association between executive function and decision-making capacity in subjects consenting to a noninvasive research protocol. Method Subjects consenting to a noninvasive research protocol (N = 21; mean age: 65.5 [standard deviation: 9.2] years) were administered a modified version of The MacArthur Competency Assessment Tool–Treatment (MacCAT-T), Executive Interview (EXIT25), Executive Clock Drawing Task (CLOX), and Mini-Mental State Examination (MMSE). Results ...
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Sep 1, 2005·Psychosomatics2.39
#1Jason E. Schillerstrom (University of Texas Health Science Center at San Antonio)H-Index: 8
#2Monica S. Horton (University of Texas Health Science Center at San Antonio)H-Index: 4
Last. Donald R. Royall (University of Texas Health Science Center at San Antonio)H-Index: 51
view all 7 authors...
The purpose of this study was to determine the prevalence, course, and risk factors for executive impairment in patients hospitalized on a general medicine service. One hundred patients were administered the Executive Interview (EXIT25), the Executive Clock Drawing Task (CLOX), and the Mini-Mental State Examination at admission and discharge. Fifty-two percent of the patients at admission and 56% at discharge had scores indicating impairment on at least one measure of executive function. Median ...
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Background. It is unclear how early cognitive impairment affects future care needs. Furthermore, the Mini-Mental State Examination (MMSE), a commonly used screening tool in the clinical setting, tends to have a ceiling effect for early cognitive decline. One of the earliest changes in cognitive function is executive impairment. We examined the relationship between executive function, measured with a clock drawing protocol (CLOX1) designed to capture executive impairment, and incident need for in...
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Jun 1, 2005·Journal of the National Cancer Institute13.51
#1Lara H. Heflin (SC: University of Southern California)H-Index: 2
#2Beth E. MeyerowitzH-Index: 34
Last. Margaret GatzH-Index: 92
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Previous studies have shown that cancer survivors frequently experience short-term cognitive defi cits, but it is unknown how long these defi cits last or whether they worsen over time. Using a co-twin control design, the cognitive function of 702 cancer survivors aged 65 years and older was compared with that of their cancer-free twins. Dementia rates were also compared in 486 of the twin pairs discordant for cancer. Cancer survivors overall, as well as individuals who had survived cancer for 5...
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Oct 1, 2004·American Journal of Clinical Oncology2.49
#1Carol A. HahnH-Index: 23
#2R.H. DunnH-Index: 3
Last. Edward C. HalperinH-Index: 47
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Purpose: Depression is a debilitating illness with symptoms that overlap those of cancer and radiotherapy. We sought to measure the frequency of depression in adult radiation oncology patients. Methods and Materials: The Beck Depression Inventory-II (BDI-II) was incorporated into routine clinical evaluation of patients. Results were analyzed by univariate analysis and multivariate analysis of variance (MANOVA). Results: One hundred twenty-four patients were screened and 19 (15%) endorsed signifi...
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Jul 1, 2004·Journal of The National Cancer Institute Monographs
#1Mary Jane Massie (MSK: Memorial Sloan Kettering Cancer Center)H-Index: 20
Depression is the psychiatric syndrome that has received the most attention in individuals with cancer. The study of depression has been a challenge because symptoms occur on a broad spectrum that ranges from sadness to major affective disorder and because mood change is often difficult to evaluate when a patient is confronted by repeated threats to life, is receiving cancer treatments, is fatigued, or is experiencing pain. Although many research groups have assessed depression in cancer patient...
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Oct 1, 2003·Journal of Clinical Oncology44.54
#1Christina A. Meyers (University of Texas MD Anderson Cancer Center)H-Index: 70
#2Jeffrey S. WefelH-Index: 22
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Jul 1, 2003·Psychosomatics2.39
#1Jason E. Schillerstrom (University of Texas Health Science Center at San Antonio)H-Index: 8
#2Melissa S. Deuter (University of Texas Health Science Center at San Antonio)H-Index: 1
Last. Donald R. Royall (University of Texas Health Science Center at San Antonio)H-Index: 51
view all 5 authors...
The prevalence of impairment of executive function among 50 medical inpatients referred for psychiatric consultation was assessed by using the Executive Interview (EXIT25) and an executive clock-drawing task (CLOX). The Mini-Mental Status Examination (MMSE) was also administered to assess general cognition. The percentage of patients who failed each test was calculated. Seventy-two percent failed at least one measure of executive function, whereas only 30% failed the MMSE. The results suggest th...
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Cited By9
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Mar 10, 2020·Expert Review of Hematology2.93
#1Alessandro Allegra (UNIME: University of Messina)H-Index: 30
#2Vanessa Innao (UNIME: University of Messina)H-Index: 15
Last. Caterina Musolino (UNIME: University of Messina)H-Index: 22
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AbstractIntroduction: Cognitive impairment caused by chemotherapies, a condition known as chemobrain, is a possible side effect that affects alertness, learning, memory, and concentration.Areas cov...
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Jul 1, 2019·in Vivo2.15
#1Edit Biro (University of Szeged)H-Index: 3
#2Zsuzsanna Kahán (University of Szeged)H-Index: 20
Last. Csaba Hamvai (University of Szeged)H-Index: 2
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BACKGROUND/AIM: Anti-cancer therapies may deteriorate cognitive functioning, affective functioning and psychological well-being. MATERIALS AND METHODS: In this prospective longitudinal pilot study, premenopausal and postmenopausal patients received adjuvant endocrine therapy (ET) (tamoxifen with or without LHRH analog or aromatase inhibitor) or were observed only (control group). At baseline testing and 6, 12 and 24 months thereafter, cognitive, depression and anxiety tests and quality of life (...
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May 1, 2017·Psycho-oncology3.89
#1Michelle LyckeH-Index: 10
#2Lies PottelH-Index: 11
Last. Philip R. Debruyne (ARU: Anglia Ruskin University)H-Index: 17
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Introduction: Recent research in the field of cancer-related cognitive impairments (CRCI) has shown CRCI presentation prior to treatment initiation. Some have attributed these problems to worry and fatigue, whereas others have suggested an influence of age, IQ, and other psychosocial and medical factors. Methods: Patients (>= 18 years) with a histologically confirmed diagnosis of a solid cancer or hematological malignancy, scheduled for a curative treatment, were evaluated with a baseline neurop...
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Mar 1, 2013·Clínica y Salud0.70
#1Manuel HernándezH-Index: 2
#2Juan Antonio Cruzado (Complutense University of Madrid)H-Index: 8
Cancer creates an important psychological suffering that reaches clinical levels of distress in half of those who suffer from it. Cancer is accompanied by psychopathological disorders in more than 30 % of the cases, a prevalence higher than in the general population which requires specialised psychological attention. The emotional distress is high from the beginning to the end of the medical treatment and it is a risk factor for psychopathological disorders. These problems require adequate scree...
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Purpose Most patients with localized breast cancer (LBC) who take adjuvant chemotherapy (CT) complain of fatigue and a decrease in quality of life during or after radiotherapy (RT). The aim of this longitudinal study was to compare the impact of RT alone with that occurring after previous CT on quality of life. Methods and Materials Fatigue (the main endpoint) and cognitive impairment were assessed in 161 CT-RT and 141 RT patients during RT and 1 year later. Fatigue was assessed with Functional ...
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Jan 1, 2011·Methods of Molecular Biology
#1Ken-ichiro Matsumoto (NIRS: National Institute of Radiological Sciences)H-Index: 19
#2Fuminori Hyodo (Kyushu University)H-Index: 24
Last. Murali C. Krishna (NIH: National Institutes of Health)H-Index: 71
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: Nitroxyl contrast agents (nitroxyl radicals, also known as nitroxide) are paramagnetic species, which can react with reactive oxygen species (ROS) to lose paramagnetism to be diamagnetic species. The paramagnetic nitroxyl radical forms can be detected by using electron paramagnetic resonance imaging (EPRI), Overhauser MRI (OMRI), or MRI. The time course of in vivo image intensity induced by paramagnetic redox-sensitive contrast agent can give tissue redox information, which is the so-called re...
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Mar 1, 2010·Cancer Nursing2.59
#2Jill B. Hamilton (UNC: University of North Carolina at Chapel Hill)H-Index: 2
Background—Depression is becoming an increasing concern in cancer patients because of its impact on quality of life. Although risk factors of having depression have been examined in the literature, there has been no research examining these factors in older African American cancer patients. Objective—This study explores the demographic and illness-related risk factors in older African American cancer patients. Methods—Two hundred eighty-three patients were recruited from outpatient oncology clin...
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