Psychosocial factors associated with perceived cognitive functioning in prostate cancer survivors: an exploratory cross-sectional analysis

As more individuals survive prostate cancer, addressing survivorship concerns like cancer-related cognitive impairment (CRCI) becomes increasingly important. Identifying modifiable psychosocial factors related to CRCI is critical in devising targeted non-pharmacological interventions. We aimed to investigate the psychosocial factors associated with perceived cognitive functioning in prostate cancer survivors (PCS). Adult PCS, either undergoing hormone therapy or on 'watchful waiting'/ 'active surveillance', were recruited for a cross-sectional survey. Perceived cognitive functioning was measured using the Perceived Cognitive Impairments subscale (PCI20) from the Functional Assessment of Cancer Therapy- Cognitive Function questionnaire. Pearson's correlations and ANOVAs explored the association between PCI20 and psychosocial factors including psychological distress, interpersonal functioning, functional well-being, self-compassion and intellectual engagement. Significant variables were included as predictors in a hierarchical regression, examining the relationship with PCI20 and related psychosocial factors while controlling for demographic, biomedical and lifestyle factors. Of the 96 respondents, one-third reported low cognitive function. Better perceived cognitive functioning was associated with better physical well-being and functional well-being and lower depression levels. In a regression analysis with depression, physical and functional well-being as predictors, only functional well-being was a significant predictor of perceived cognitive functioning after controlling for cancer treatment and levels of physical activity. Perceived cognitive functioning was associated with self-reported quality of life and the ability to participate in day-to-day activities including work and enjoyment. The use of a biopsychosocial approach in identifying modifiable avenues for therapeutic interventions addressing CRCI may be beneficial.