ABSTRACT Background Cancer‐related cognitive impairment (CRCI) is frequently reported by women with breast cancer after chemotherapy. Yet, the acute effects of a single infusion on perceived cognition remain understudied, especially across different age groups. Aims This study assessed acute changes in perceived cognition following the first chemotherapy infusion in young (< 40 years), middle‐aged (40–64 years), and older adults (≥ 65 years) with breast cancer and identified baseline risk factors associated with worsened CRCI in these age groups. Methods Chemotherapy‐naïve women with breast cancer scheduled for intravenous chemotherapy completed PROMIS Cognitive Abilities 4a and Cognitive Function 8a assessments before and 5 days post‐infusion. Clinically significant CRCI was defined as T‐scores ≤ 45. Paired t ‐tests, chi‐square tests, and residualized regression models (univariate and multivariable) were used to evaluate changes in cognition and associated risk factors. Results Among all participants ( N = 528; 85 young, 329 middle‐aged, 114 older), perceived cognitive performance significantly declined, and the prevalence of CRCI increased across all three age groups (FDR adjusted p ‐values < 0.05). Among middle‐aged patients, the White race ( p = 0.011) and a college degree ( p = 0.001) were associated with worsened cognitive function, while a college degree ( p = 0.009) and sleep disturbance ( p = 0.012) were linked to worsened cognitive ability. In older adults, depressive symptoms were associated with worsened cognitive function ( p = 0.017) and cognitive ability ( p = 0.011). Conclusions Cognitive impairment develops acutely after the first chemotherapy infusion across all age groups, with risk factors varying by age. Age‐specific interventions are needed to address early cognitive decline in breast cancer patients.
Yang et al. (Wed,) studied this question.