|Title||Longitudinal associations between cancer history and cognitive functioning among older adults|
|Publication Type||Journal Article|
|Year of Publication||2021|
|Authors||Wang, K, Cheatham, LP, Marbut, AR, Chen, X|
|Journal||Archives of Gerontology and Geriatrics|
|Keywords||Cancer history, Chemotherapy, cognitive functioning, Middle-old adults, Mixed-effects modeling|
Objectives This study aimed to examine 1) whether cancer history accelerates older adultsâ€™ rates of cognitive decline over time and 2) whether chemotherapy increases older cancer patientsâ€™/ survivorsâ€™ rates of cognitive decline over time. Methods This longitudinal study drew a subsample of 8,811 adults aged 65 or older from Wave 6 of the Health and Retirement Study in 2002 and followed biannually until Wave 13 in 2016. Linear mixed-effects models were performed to test whether cancer history and chemotherapy were associated with accelerated rates of cognitive decline over time among older adults in different age groups. Results Middle-old adults (aged 75-84) with a cancer history had significantly reduced rates of cognitive decline over time, including the global measure of cognitive functioning (B= .16, p< .01), mental status (B= .08, p< .01), and episodic memory (B= .09, p< .05) compared to their counterparts without a cancer history. This effect was not significant for the youngest-old (aged 65-74) or oldest-old adults (aged 85 or older). Also, chemotherapy was not significantly associated with older cancer patientsâ€™/survivorsâ€™ cognitive functioning at baseline or over time in different age groups. Conclusions This study finds that cancer history and chemotherapy do not further exacerbate older adultsâ€™ cognitive functioning over time. On the contrary, cancer history shows a â€œprotectiveâ€ effect on middle-old adultsâ€™ cognitive functioning. This encouraging finding indicates that older adults can be more actively engaged in the decision-making of treatments and following care plans. Future mediation studies are needed to further investigate underlying mechanisms.