12111 Background: Up to 70% of patients with cancer experience cancer-related cognitive impairment and physical activity (PA) may prevent or mitigate this concerning symptom. However, longitudinal data on PA before and during therapy for lymphoma and their associations with cognitive function across the treatment continuum are limited. This study examined PA patterns before, during, and after chemotherapy in patients with lymphoma compared with controls, and associations between pre-chemotherapy PA and cognitive changes over time in patients only. Methods: Cognitive function was assessed via the patient-reported Functional Assessment of Cancer Therapy-Cognitive Function perceived cognitive impairment subscale, and PA via the Aerobics Center Longitudinal Study questionnaire at pre-chemotherapy (T1), 1 month post-chemotherapy (T2), and 6 months following T2 (T3) in patients with lymphoma and age- and sex-matched non-cancer controls recruited from 19 NCORP sites across the US. MET-hours per week (MET-hrs/wk) were calculated, and meeting PA guidelines was defined as ≥150 minutes/week of moderate intensity or ≥75 minutes/week of vigorous intensity PA, or an equivalent combination. Linear mixed-effects models (LMMs) examined longitudinal PA changes between patients and controls and pre-chemotherapy PA’s association with cognitive changes in patients only, adjusting for age, sex, race, education, cognitive reserve, BMI, anxiety, and depression at T1. Results: Participants included 242 patients with lymphoma (74.4% non-Hodgkin) and 209 controls (mean age SD, 55.3 14.8 vs 53.7 14.9 years; male, 62.8% vs 58.9%). In patients, 36.8% met PA guidelines at T1, decreasing to 23.3% at T2 and rising to 40.8% at T3, whereas about half of controls met guidelines across T1-T3 ( p < 0.05 at T1 and T2). Compared to controls, patients had lower PA (MET-hrs/wk) at T1 ( β95% CI -4.81-9.64, 0.02; p =0.051), which declined to T2, resulting in significantly lower PA at T2 ( β95% CI -7.48-11.93, -3.03; p =0.001); from T2 to T3, PA increased more in patients vs controls ( β95% CI 6.382.31, 10.45; p =0.002), reaching comparable levels at T3. Cognition declined from T1 to T2 in patients meeting ( β95% CI -11.42-15.19, -7.66; p <0.001) and not meeting ( β95% CI -9.29-12.09, -6.49; p <0.001) PA guidelines at T1; however, only those meeting guidelines showed cognitive recovery from T2 to T3 ( β 95% CI 3.640.28, 7.00; p =0.034). Conclusions: In patients with lymphoma, PA significantly declined during chemotherapy; despite recovery to pre-treatment levels by 6 months post-chemotherapy, most remained insufficiently active. Further, active patients before treatment showed cognitive recovery after chemotherapy, suggesting that pre-chemotherapy PA may support post-treatment cognitive resilience, warranting further investigation.
Zhao et al. (Wed,) studied this question.