528MO - Cognitive phenotypes and its association with role functioning outcomes in Adolescents and Young Adults (AYAs) with cancer

Background

There is little data on the common phenotypes of cognitive problems and how they affect functional outcomes after cancer treatment. This study aims to characterize the phenotypic profile of cognitive complaints and assess its impact on work/school, home and social functioning in Chinese AYAs (15 to 39 years old) with cancer.

Methods

This study recruited 421 AYAs living with cancer (female 59.6%, mean age 31.50, SD=8.36 years) from two public hospitals. The participants completed the validated CCSS-Neurocognitive Questionnaire (NCQ) to report their cognitive complaints in memory, task efficiency, organization, and emotional regulation. Their role functioning in performing work/school, home and social activities was assessed using the Life Functioning Questionnaire. The patterns of cognitive problems across the 4 NCQ domains were determined by latent class analysis. Multinomial logistic regression was used to identify predictors (diagnosis, treatment exposures, symptom burden) of cognitive phenotypes and their association with role functioning, adjusted for sex and age.

Results

With reference to community controls, 42.6% reported problems in ≥1 cognitive domain, particularly higher-order domains of organization (20.4%) and emotional regulation (22.3%). Three cognitive phenotypes were identified (global impairment 22.6%, higher-order cognition-specific impairment 48.2%, others/no impairment 29.2%). Risk of global impairment was associated with CNS tumor diagnosis (OR=4.24, 95%CI 1.20-15.0) and radiotherapy (OR=1.97, 95%CI 1.04-3.73). Potentially modifiable risk factors, like physical symptom burden (OR=1.07, 95%CI 1.03-1.11) and psychological symptom burden (OR=1.13, 95%CI 1.09-1.17), predicted global impairment. More AYAs with “global impairment” (26.3%) reported poor school/work functioning than AYAs in the "higher-order cognition-specific impairment" (12.3%) and "others/no impairment" classes (5.7%; p<0.001). A similar trend was observed in other domains of role functioning (p<0.001).

Conclusions

Our results support the clinical utility of cognitive phenotyping to develop risk profiles in functional outcomes, particularly work/school functioning, in AYAs with cancer.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

CUHK Pharmacy.

Funding

Research Grant Council (Hong Kong) Reference no: 14604022.

Disclosure

All authors have declared no conflicts of interest.