Cognitive aging in long-term breast cancer survivors

长期乳腺癌幸存者的认知衰老

• 批准号: 10566264
• 负责人: James C Root
• 金额: $ 73.11万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10566264
• 关键词: Acceleration; Activities of Daily Living; Acute; Address; Aftercare; Age; Age Years; Aging; Biological Aging; Brain; Breast Cancer survivor; Cancer Survivor; Cancer Survivorship; Cardiovascular Diseases; Clinical; Cognition; Cognitive; Cognitive aging; Cognitive deficits; Collection; DNA; Data; Development; Diagnosis; Discrimination; Disease; Education; Enrollment; Ethnic Origin; Goals; Impaired cognition; Individual; Intervention; Malignant Neoplasms; Masks; Measures; Medical; Methods; Neurocognitive; Neuropsychology; Obesity; Outcome; Pattern; Performance; Phase; Polypharmacy; Psychometrics; Race; Recording of previous events; Research; Research Personnel; Risk Factors; Saliva; Sampling; Small Business Innovation Research Grant; Smoking; Survivors; Time; Toxic effect; United States National Institutes of Health; Work; apolipoprotein E-4; breast cancer diagnosis; cancer therapy; cancer-related cognitive impairment; clinically relevant; cognitive change; cognitive control; cognitive function; cognitive neuroscience; cognitive performance; cognitive reserve; cognitive testing; cohort; comorbidity; comparison control; design; frailty; human old age (65+); improved; indexing; innovation; longitudinal design; malignant breast neoplasm; psychologic; psychosocial; recruit; remote administration; remote assessment; remote delivery; response; social; therapy design; treatment effect

ABSTRACT Despite significant progress in understanding cognitive change associated with cancer and cancer treatments, little is known regarding longer-term cognitive outcomes over developmentally meaningful intervals in older age (5-20 years post-treatment) and potential association with frailty. Previous work from our lab and others, focusing on the direct effects of cancer and cancer treatment, has moved the field forward for a better understanding of these direct effects but is limited with regard to tracking long-term cognitive trajectories due to 1) focus on cognition before and after treatment and short intervals following treatment completion; 2) longitudinal designs that introduce practice effects and selective attrition that distort true cognitive trajectories; and 3) short intervals that also limit the ability to assess accumulation of deficits, i.e., frailty, to potentially associate with cognitive declines. We will assess cognition in 210 cancer survivors diagnosed between 55 and 60 years of age and 210 non-cancer controls at three cross-sectional age bands: 65-69; 70-74; 75-80. Cognitive assessment will consist of online, remote administration of a validated platform of cognitive-experimental measures for use in cancer survivorship and standard neuropsychological measures, together with collection of cancer and treatment variables. Frailty as indexed by accumulation of deficits, i.e., medical comorbidities, polypharmacy, social detriments of disease (e.g., smoking, obesity), psychological disturbance, and functional limitations / declines in activities of daily living, will be collected in parallel. Aim 1: Examine cognitive differences and trajectories between breast cancer survivors and age and education matched controls controlling for cognitive reserve and APOE. Aim 2: Examine the association of deficit accumulation with cognition and interaction with group status. Aim 3: Explore potential associations between APOE status and deficit accumulation and combined effects on cognition. This research is significant because cancer and cancer treatments have been identified as disease drivers of aging and deficit accumulation and has significant clinical implications in that interventions that reduce deficit accumulation may be effective in maintaining cognitive function. This research is innovative because it utilizes a cross-sectional design that avoids practice effects and cognitive neuroscience measures that allow for assessment of cognitive trajectories and their association with deficit accumulation at developmentally relevant timespans.

抽象的 尽管在理解与癌症和癌症治疗相关的认知变化方面取得了重大进展，但 关于长期认知结果，在年龄较大的时间间隔内的长期认知结果知之甚少 （治疗后5 - 20年）和与脆弱的潜在关联。我们实验室和其他人的先前工作，专注于 关于癌症和癌症治疗的直接影响，已将现场向前发展，以更好地理解 这些直接影响，但在跟踪长期认知轨迹的方面受到限制 治疗之前和之后的认知和治疗完成后短时间间隔； 2）纵向设计 引入实践效果和选择性损耗，使真正的认知轨迹扭曲； 3）短时间间隔 这也限制了评估缺陷积累的能力，即脆弱的能力，可能与认知能力联系在一起 下降。我们将评估210个诊断为55至60岁的癌症幸存者和210岁的认知 三个横截面年龄段的非癌症控制：65-69； 70-74; 75-80。认知评估将组成 在线，远程管理经过验证的认知实验措施的平台 生存和标准神经心理学措施以及癌症和治疗的收集 变量。由于缺陷的积累，即医学合并症，多药，社会，脆弱 疾病（例如吸烟，肥胖），心理障碍和功能限制 /下降的损害 日常生活的活动将并行收集。目标1：检查认知差异和轨迹 乳腺癌幸存者与年龄和教育之间的控制能力控制 储备和Apoe。目标2：检查赤字积累与认知和 与组状态的互动。目标3：探索APOE状态与赤字之间的潜在关联 积累和对认知的综合影响。这项研究很重要，因为癌症和癌症 治疗已被确定为衰老和赤字积累的疾病驱动因素，并具有明显的临床 在这种干预措施中减少赤字积累的含义可能有效地维持认知 功能。这项研究具有创新性，因为它利用了避免练习效应和的横截面设计 认知神经科学措施允许评估认知轨迹及其与之关联 在发育相关的时间班上的赤字积累。