Aging, obesity, and post-therapy cognitive recovery in breast cancer survivors

// Zhezhou Huang 1 , Ying Zheng 2 , Pingping Bao 3 , Hui Cai 4 , Zhen Hong 5 , Ding Ding 5 , James Jackson 6 , Xiao-Ou Shu 4 and Qi Dai 4 1 Department of Elderly Health, Division of Noncommunicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China 2 Department of Cancer Control and Prevention, Division of Noncommunicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China 3 Department of Noncommunicable Disease Surveillance, Division of Noncommunicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China 4 Department of Medicine, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA 5 Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China 6 Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA Correspondence to: Ying Zheng, email: // Keywords : breast cancer survivor, cognitive, age, obesity, physical activity Received : June 21, 2016 Accepted : October 03, 2016 Published : October 11, 2016 Abstract Therapy-induced cognitive impairment is prevalent and long-lasting in cancer survivors, but factors affecting post-therapy cognitive recovery are unclear. We conducted this study to evaluate the associations of age, body mass index (BMI), waist-to-hip ratio (WHR), and physical activity (PA) with post-therapy cognitive changes in a population-based breast cancer (BC) survivor cohort. We collected information on PA, weight, height, waist and hip circumferences of 1286 BC survivors aged 20-75. We assessed their cognitive functions, including immediate memory, delayed memory, verbal fluency, and attention, at 18 and 36 months after cancer diagnosis. Linear regression models were used to examine the associations of age, BMI, WHR and PA with mean changes in cognitive scores from 18- to 36-month follow-up interview. We found that the post-therapy cognitive changes differed by age and obesity status. Verbal fluency and attention improved in younger patients aged <60 and non-abdominally obese patients, but deteriorated in older patients aged ≥60 (i.e. verbal fluency and attention) and abdominally obese patients (i.e. verbal fluency). Memory improved in all patients, with a smaller improvement in obese patients compared with normal-weight patients. No significant association was found between PA and post-therapy cognitive change. Due to the novelty of our findings and the limitations of our study, further research, including intervention trials, is warranted to confirm the causal relationship between obesity and cognitive impairments.