Effects of a cognitive training program on cancer-related cognitive impairment in breast cancer patients in active treatment: a randomized controlled trial

Cancer-related cognitive impairment (CRCI) is a frequent and distressing complication in women undergoing active treatment for breast cancer. Although cognitive training has shown promise as a non-pharmacological strategy, evidence on ecologically valid interventions during active treatment remains limited. To evaluate the efficacy of an everyday cognition-based training program on cognitive function and related psychological and functional outcomes in women with breast cancer receiving active treatment. In this randomized controlled trial, 50 women newly diagnosed with breast cancer (within 6 months) were allocated (1:1) to either an Intervention Group ( n = 25; receiving a 4-month structured home-based daily cognitive training program of 80 real-life activities plus Health Education) or a Control Group ( n = 25; receiving Health Education alone). The control group received a health education program. Co-primary outcomes were objective cognitive performance (MoCA) and subjective cognitive function (FACT-Cog). Secondary outcomes included everyday cognition (PECC), anxiety (Hamilton scale), sleep quality (PSQI), functional independence (Lawton & Brody), performance status (ECOG), and subjective memory complaints (MFF). Assessments were conducted at baseline and post-intervention (4 months). After adjusting for baseline scores using ANCOVA, the intervention group demonstrated a statistically significant improvement in perceived cognitive abilities (FACT-Cog PCA domain; \(\:F=24.60\) , \(\:p<0.001\) , \(\:{η\:}ₚ²=0.35\) ) compared to the control group. In contrast, no significant between-group differences were observed for objective global cognitive performance (MoCA; \(\:F=0.03\) , \(\:p=0.856\) ) or other FACT-Cog subscales. Everyday cognition (PECC) showed a positive unadjusted trend ( \(\:p=0.066\) , \(\:d=0.57\) ), which did not remain statistically significant in baseline-adjusted models ( \(\:p=0.614\) ). No significant intervention effects were detected for anxiety, sleep quality, functional independence, performance status, or subjective memory complaints after baseline adjustment. A structured everyday cognition-based training program improves perceived cognitive abilities during active breast cancer treatment. However, no significant effects were confirmed for objective cognitive screening scores or general functional outcomes.