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， 关于老年时期对发育有意义的时间间隔的长期认知结果知之甚少 （治疗后 5-20 年）以及与虚弱的潜在关联。我们实验室和其他人之前的工作重点是 关于癌症和癌症治疗的直接影响，推动了该领域的发展，以便更好地了解 这些直接影响，但在跟踪长期认知轨迹方面受到限制，因为 1) 关注 治疗前后的认知以及治疗完成后的短暂间隔； 2) 纵向设计 引入实践效应和选择性损耗，扭曲真实的认知轨迹； 3）短间隔 这也限制了评估缺陷累积的能力，即虚弱，可能与认知相关 拒绝。我们将评估 210 名年龄在 55 至 60 岁之间的癌症幸存者以及 210 名癌症幸存者的认知能力。 三个横截面年龄范围的非癌症对照：65-69； 70-74； 75-80。认知评估将包括 在线远程管理用于癌症的认知实验测量验证平台 生存和标准神经心理学测量，以及癌症收集和治疗 变量。以缺陷累积为指标的虚弱，即医疗合并症、多药治疗、社交 疾病危害（例如吸烟、肥胖）、心理障碍和功能限制/下降 日常生活活动将同时收集。目标 1：检查认知差异和轨迹 乳腺癌幸存者与年龄和教育程度相匹配的对照控制认知 储备和 APOE。目标 2：检查赤字累积与认知和能力的关系 与群体状态的互动。目标 3：探索 APOE 状态与缺陷之间的潜在关联 积累和对认知的综合影响。这项研究意义重大，因为癌症和癌症 治疗已被确定为衰老和缺陷积累的疾病驱动因素，并且具有重要的临床意义 减少赤字累积的干预措施可能有效维持认知能力 功能。这项研究具有创新性，因为它采用了横截面设计，避免了实践影响， 认知神经科学测量可以评估认知轨迹及其与 与发展相关的时间跨度的赤字积累。