Cluster | Etiology | Reference | Study Design | Findings |
Iatrogenic | Long-term adjuvant endocrine therapy | Van Dyke, et al. [7] | Prospective longitudinal | No association found between long-term endocrine therapy and neurocognitive performance |
Major oncologic surgery | Plas M, et al. [8] | Prospective longitudinal | - 12% of patients overall exhibit cognitive decline at 3-months following major oncologic surgery - 18% of patients aged >75 years exhibit cognitive decline at 3 months following major oncologic surgery | |
Chronic opioid usage | Kurita GP, et al. [9] | Prospective cross-sectional, multi-center | - A third of opioid-treated patients exhibit possible (MMSEa score 24 - 26) or definite (MMSE score < 24) cognitive dysfunction - Patients receiving daily dose of 400 mg or more had 1.75 times higher odds of having a lower MMSE score compared with those receiving daily dose lower than 80 mg | |
Cancer-related comorbidities | Post-traumatic stress | Hermelink, et al. [18] | Prospective longitudinal | Cancer patients exhibited subtle cognitive deficits, irrespective of chemotherapy, which is mediated by post-traumatic stress |
Fatigue | Menning, et al. [13] | Prospective longitudinal | Cancer patients exhibited cognitive impairment prior to receipt of chemotherapy; effect was mediated by fatigue and not observed when fatigue accounted for | |
Depression | Polsky, et al. [14] | Prospective longitudinal | Hazard Ratio = 3.55 (95% CI 2.79 - 4.52) for depressive symptoms within 2 years following a cancer diagnosis | |
Other | Age-related cognitive decline | American Cancer Society [3] | Epidemiologic | 47% of cancer survivorships in the US is 70 years of age or older |