The prevalence of mild cognitive impairment in breast cancer patients receiving chemotherapy according to the criteria of the National Institute on Aging-Alzheimer’s Association (NIA-AA).

Abstract

Abstract Purpose Breast cancer patients receiving chemotherapy can develop cognitive impairment. There is no gold standard for defining cognitive impairment. We applied the National Institute on Aging- Alzheimer’s Association (NIA-AA) criteria for mild cognitive impairment (MCI) to determine its prevalence in breast cancer patients receiving adjuvant chemotherapy and examine differences between patients with and without MCI. Methods Existing cognitive data of 240 breast cancer patients who received adjuvant conventional (n = 154) or high-dose chemotherapy (n = 86) on 5 neuropsychological test outcomes measuring verbal memory, processing speed, executive functioning and verbal fluency was used. Testing occurred 6 or 12 months post-chemotherapy and results were compared to 66 women without cancer. MCI was defined by; i) presence of concern regarding a change in cognition, ii) impairment in one or more cognitive tests (1.5 Standard Deviation below a normative mean), iii) preservation of independence in functional abilities, and iv) no dementia. Results 20% (n = 49) of breast cancer patients who received chemotherapy (conventional therapy n = 29 (12%), high-dose therapy = 20 (8.3%)) met criteria for MCI, compared to 7.6% (n = 5) of controls. Prevalence was significantly different between the groups (P = 0.020) and corrected for IQ (P < 0.001). Patients with MCI had significant lower education levels (P < 0.002) and premorbid IQ (P = 0.001) compared to patients without MCI. Conclusion 20% of breast cancer patients treated with chemotherapy met NIA-AA criteria for MCI, compared to 7.6% of the controls. These criteria, which include formal test performance as well as a person's symptoms and functional status, can be useful in clinical practice and scientific research.