Abstract A029: Use and predictors of perceived cognitive function using the Neuro-QoL perceived cognitive function scale in patients with primary brain tumors

Abstract Background: Cognitive dysfunction is a commonly reported symptom in the primary brain tumor (PBT) population but is associated with substantial heterogeneity in both the course and severity. Brief, reliable, and sensitive measures of patient-perceived impact of cognitive symptoms are needed for clinical care and research. This study aims to describe the prevalence and predictors of cognitive dysfunction in PBT patients enrolled in a natural history study (NCT02851706: PI T. Armstrong). Methods: Clinical and demographic characteristics and patient-reported outcomes (PRO), including symptom burden (MD Anderson Symptom Inventory-Brain Tumor (MDASI-BT) using symptom burden, interference, and cognitive symptom factor scores) ; perceived cognition (Neuro-QoL Cognitive Function) ; and anxiety/depression (Patient-Reported Outcomes Measurement Information System Anxiety and Depression Short Forms) were collected and characterized using descriptive statistics. Neuro-QoL Cognitive Function T-scores 40 indicate moderate-severe (MS) cognitive dysfunction. Univariate tests on cognitive dysfunction included chi-square tests and independent samples t-tests with p-value 0. 10. Variables significantly associated with MS outcome were then included in a subsequent multivariate logistic regression with backward selection. Clinical variables and PROs were evaluated separately, then combined for a final multivariate model with p-value 0. 05. Results: The cohort included 327 patients median age: 47 years (range: 18-85), primarily white (78%) males (55%) with high-grade tumors (73%), most commonly with glioblastoma (36%), with 26% reporting cognitive dysfunction as a presenting symptom. Sixty-five percent had a Karnofsky Performance Status (KPS) ≥ 90, 73% had received radiation, and 44% had experienced one or more tumor recurrences. MS cognitive dysfunction was reported in 29% of patients. At the univariate level, age, employment status, cognitive symptoms at presentation, current corticosteroid use, anti-convulsant use, KPS, and number of surgeries were significant clinical predictors of MS cognitive dysfunction; as were, separately, worsening symptom burden, interference, cognitive symptom factor, anxiety, and depression. Evaluated together, a final multivariate model found increasing scores on symptom interference and cognitive symptom factor increased the likelihood of MS cognitive dysfunction (interference OR=1. 25, 95% CI 1. 09, 1. 44, p0. 001; cognitive symptom factor OR=1. 81, 95% CI 1. 50, 2. 19, p0. 001) with 84% classification rate. Conclusion: Understanding the impact and prevalence of cognitive functioning is essential for PBT patient care and identifying supportive care interventions. Findings indicate self-report of cognitive symptoms and interference of symptoms with daily living contribute to moderate-to-severe cognitive dysfunction. Future research in cognitive function will compare self-report with objective assessment, explore its predictors in select populations (i. e. , IDH-mutant tumors), and examine its association with biomarkers. Citation Format: Morgan L. Johnson, Elizabeth Vera, Kimberly Reinhart, Hope Miller, Anna Choi, Tricia Kunst, Jennifer Reyes, Tito Mendoza, Terri S. Armstrong. Use and predictors of perceived cognitive function using the Neuro-QoL perceived cognitive function scale in patients with primary brain tumors abstract. In: Proceedings of the AACR Special Conference on Brain Cancer; 2023 Oct 19-22; Minneapolis, Minnesota. Philadelphia (PA): AACR; Cancer Res 2024;84 (5 Suppl₁): Abstract nr A029.