Introduction/Background Based largely on data from retrospective studies it has been postulated that chemotherapy has an aggravating effect on the cognitive function of breast cancer patients. Potential individual factors related to the effect of chemotherapy on cognitive function have been indicated, such as age-related cognitive dysfunction and stress. Elderly patients differ from non-elderly for higher cognitive related comorbidities, such as dementia, as well as for lower stress levels, indicating that chemobrain may affect differentially these two age groups. The aim of this review is to investigate the effect of stress and chemotherapy on the cognitive dysfunction and identify any potential age-related differences in breast cancer patients treated with adjuvant chemotherapy.
Methodology A systematic review of the literature was carried out on Medline, Scopus and Web of Science. The inclusion criteria were original articles published in peer-reviewed journals, elderly and non-elderly patients with breast cancer, reporting on stress and at least one cognitive parameter pre- and/or post-treatment.
Results Eight studies met the preset criteria and were further analyzed. 1253 women participated, of whom 800 breast cancer patients treated with surgery only, systemic treatment only, or both. Although all studies included a non-elderly breast cancer patient subpopulation, just two of the studies included patients over 65 years of age. All studies indicated a statistically significant association of stress with various domains of cognitive dysfunction in patients compared to controls, as shown by either self-completed questionnaires, neuropsychological testing or both. Age over 60 was linked to fewer cognitive difficulties mediated by lower levels of stress.
Conclusion The evidence supports the association of stress with cognitive deficits in breast cancer patients, regardless of the type of cancer-related treatment. Therefore, stress should be addressed appropriately. Further research is needed to investigate the correlation of stress with cognitive function in elderly patients with breast cancer.
Disclosure Nothing to disclose
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