Summary: Higher levels of inflammatory C-reactive protein have been found in older breast cancer survivors who had cognitive problems. The study is one of the first long-term assessments linking chronic inflammation to cognitive decline in breast cancer survivors.
Source: UCLA
Scientists are still trying to understand why many breast cancer survivors experience troubling cognitive issues for years after treatment. Inflammation is a possible culprit.
A new long-term study of elderly breast cancer survivors published today in the Journal of Clinical Oncology and co-led by UCLA researchers adds important evidence to this potential link.
Higher levels of an inflammatory marker known as C-reactive protein (CRP) were linked to older breast cancer survivors reporting cognitive problems in the new study.
“Blood tests for CRP are routinely used in the clinic to determine heart disease risk. Our study suggests that this common test for inflammation may also be a risk indicator for cognitive problems reported by breast cancer survivors” said the study’s lead author, Judith Carroll, associate professor of psychiatry and biobehavioral sciences and faculty member of the Cousins Center for Psychoneuroimmunology at UCLA and UCLA Jonsson Comprehensive Cancer Center.
The study, called the Thinking and Living with Cancer (TLC) Study, is one of the first long-term efforts to examine the potential link between chronic inflammation and cognition in breast cancer survivors aged 60 and over. more, who make up the majority of the nearly 4 million breast cancer survivor population in the United States.
Previous research has largely focused on younger women and women immediately after treatment, making it difficult to draw conclusions about the role of CRP in long-term cognitive problems in older cancer survivors. breast.
In TLC, teams of researchers across the country have spoken to and obtained blood samples from hundreds of breast cancer survivors and cancer-free women up to 6 times in 5 years. The study was prompted by testimonies from survivors and advocates that cognitive issues are one of their primary concerns.
“Cognitive problems affect women’s daily lives years after treatment ends, and their reports of their own ability to complete tasks and remember things were the strongest predictor of problems in this study,” the co-author said. -Lead author of the study, Dr. Jeanne Mandelblatt, a professor of oncology at Georgetown University who leads the TLC study.
“Being able to test levels of inflammation at the same time that cognition was rigorously assessed gave the TLC team a potential window into the biology underlying cognitive problems,” said Elizabeth C. Breen, professor emeritus of psychiatry and of Biobehavioral Sciences at the Cousins Center for Psychoneuroimmunology at UCLA, who also served as a co-lead author on the study.
Cognition, from each woman’s perspective, was assessed through a commonly used questionnaire assessing how women perceived their ability to remember things like names and direction, ability to concentrate, and other aspects. everyday.
The study found that higher CRP levels in survivors were predictive of lower cognitive function reported in breast cancer survivors. There was no similar relationship between CRP levels and cognition reported in women without cancer.
Cognitive performance, measured by standardized neuropsychological tests, did not show a link between CRP and cognition. The authors say this may indicate that women are more sensitive to differences in their daily cognitive function, self-report changes that other tests miss.
The authors said their study supports the need for research into whether interventions that can reduce inflammation — including increased physical activity, better sleep and anti-inflammatory medications — can prevent or reduce cognitive problems in people. elderly breast cancer survivors.
Other study authors include Zev M. Nakamura, Brent J. Small, Xingtao Zhou, Harvey J. Cohen, Tim A. Ahles, Jaeil Ahn, Traci N. Bethea, Martine Extermann, Deena Graham, Claudine Isaacs, Heather SL Jim, Paul B Jacobsen, Brenna C. McDonald, Sunita K. Patel, Kelly Rentscher, James Root, Andrew J. Saykin, Danielle B. Tometich, Kathleen Van Dyk, and Wanting Zhai. The authors have declared no conflict of interest.
About this cancer research, cognition and inflammation news
Author: Jason Millman
Source: UCLA
Contact: Jason Millman – UCLA
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Original research: Access closed.
“Elevated C-Reactive Protein and Subsequent Patient-Reported Cognitive Problems in Elderly Breast Cancer Survivors: The Thinking and Living with Cancer Study” by Judith Carroll et al. Journal of Clinical Oncology
Summary
See also
Elevated C-Reactive Protein and Subsequent Patient-Reported Cognitive Problems in Elderly Breast Cancer Survivors: The Thinking and Living with Cancer Study
OBJECTIVE
To examine longitudinal relationships between C-reactive protein (CRP) levels and cognition in older breast cancer survivors and non-cancer controls.
METHODS
English-speaking women aged ≥60 years, newly diagnosed with primary breast cancer (stage 0-III) and frequency-matched controls were recruited from September 2010 to March 2020; women with dementia, neurological disorders and other cancers were excluded. Assessments took place before treatment/registration and at annual visits up to 60 months. Cognition was measured using the Functional Assessment of Cognitive Function of Cancer Treatment and neuropsychological testing. Linear mixed effects models tested survivor-control differences in natural log (ln) transformed CRP at each visit. Random effect and lagged fluctuation models tested the directional effects of ln-CRP on later cognition. All models controlled for age, race, study site, cognitive reserve, obesity, and comorbidities; secondary analyzes assessed whether depression or anxiety affected the results.
RESULTS
There were 400 survivors and 329 controls with CRP samples and follow-up data (mean age 67.7 years, range: 60-90 years). The majority of survivors had stage I tumors (60.9%), estrogen receptor positive (87.6%). Survivors had a significantly higher mean adjusted ln-CRP than controls at baseline and at the 12, 24, and 60 month visits (all P < .05). Higher adjusted ln-CRP predicted lower participant-reported cognition at subsequent visits in survivors, but not controls (P interactions = 0.008); effects were unaffected by depression or anxiety. Overall, survivors had adjusted Functional Assessment of Cancer Treatment and Cognitive Function scores 9.5 and 14.2 points lower than controls at CRP levels of 3.0 and 10, 0mg/L. Survivors performed worse on neuropsychological tests (v controls), with significant interactions with CRP only for the Trails B test.
CONCLUSION
Longitudinal relationships between CRP and cognition in older breast cancer survivors suggest that chronic inflammation may play a role in the development of cognitive problems. CRP testing could be clinically useful in survivorship care.
