Cancer-related cognitive impairment in patients with newly diagnosed aggressive lymphoma compared to population norms and healthy controls: an exploratory study

Abstract

Abstract Purpose Cancer-related cognitive impairment is an adverse consequence of cancer and its treatment. There has been little research with patients with aggressive lymphoma. We describe self-reported cognitive function and neuropsychological performance data in patients with lymphoma and compare them with healthy controls and population norms. Associations between patients’ neuropsychological performance, cognitive function and distress are also examined. Methods Secondary analysis of data from a longitudinal feasibility study of 30 participants with newly diagnosed aggressive lymphoma and 72 healthy controls was performed. Participants completed validated self-report measures and neuropsychological tests before, and 6–8 weeks after chemotherapy. Healthy controls completed the FACT-Cog and neuropsychological tests at enrolment and six-months later. Mixed models were used to analyse FACT-Cog and neuropsychological test scores. Kendall’s Tau provided a measure of association between global deficit and data from other measures. Results Patients and healthy controls were well matched on demographics. Differences between the two groups’ neuropsychological test scores were mostly large-sized; patients’ performance was poorer both before and after chemotherapy (most p < 0.001). The same pattern was observed for impact of perceived cognitive impairment on quality-of-life (both p < 0.001), but not perceived cognitive impairment or abilities (all p > 0.10). Associations between neuropsychological performance, self-reported cognitive function and distress, were trivial to small-sized (all p > 0.10). Conclusion For many patients with aggressive lymphoma, impaired neuropsychological test performance and impact of perceived impairments on quality-of-life precede chemotherapy and are sustained 6–8 weeks after chemotherapy. Our data support the need for further longitudinal studies with this population to better understand targets for interventions to address cognitive impairment.