Pilot Study on Breast Cancer, Chemotherapy, Age and Ufov

Adams-Price, Carolyn

Abstract

This RO3 application addresses the NIA (PAR-02-049) objective, """"""""Cancer in the Elderly"""""""" (#7) and is relevant to """"""""Basic research in Behavioral Medicine"""""""" (#8), """"""""Cognition in Context"""""""" (#12), and """"""""Improved Measures and Methods"""""""" (#24). The incidence of breast cancer rises dramatically for post-menopausal women and increases with age. Exposure adjusted crash risk rises with age, and scores on cognitive indicators that are highly associated with important daily activities, such as driving, also tend to decline with age. Chemotherapy is a standard treatment for breast cancer and has been associated with poorer performance on neuropsychological tests. However, effects of chemotherapy on cognitive test performance that is most closely associated with everyday functioning, such as driving, have not been examined nor have interactions between age and chemotherapy on cognitive functioning. We will conduct an innovative pilot study to explore whether chemotherapy for breast cancer is associated with impaired performance on a cognitive test that is highly related to performance of important activities, including driving. We will use as a measure the UFOV, a test of visual attention/cognitive processing speed, that correlates highly with IADLs, including driving as well as crash risk. Despite its possible relevance, the UFOV has not been used in chemotherapy studies. This study will focus on three age groups--< 50, 51-69, and 70 and above and will explore age by chemotherapy interactions. The sample will include 35-50 breast cancer survivors who have completed chemotherapy, and 35-50 age-, race-, and education-matched controls. Participants will also be tested on other cognitive tests to compare findings of this study to previous studies. Data on driving behavior, subjective neuropsychological symptoms, depression and positive protective factors will be collected to explore relationships between actual deficits, perceived deficits, protective factors, and driving behavior. Findings of chemotherapy-associated deficits may be important for the safety and independence of breast cancer survivors and may assist in designing interventions. This study will provide critical information for planning a definitive study of effects of chemotherapy and of age/chemotherapy interactions on cognitive functions.