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Cognitive Function and Exercise Adherence in Early-Stage Breast Cancer

November, 11, 2023 | Breast Cancer

KEY TAKEAWAYS

  • This study analyzed moderate-intensity aerobic exercise’s impact on improving cognitive function over a 6-month endocrine therapy period in ESBC patients.
  • Aerobic exercise could enhance cognitive function in women with ESBC, particularly with consistent adherence to the regimen.

Many women undergoing endocrine therapy for early-stage breast cancer (ESBC) experience cognitive issues. Aerobic exercise has been proven to improve cognitive abilities in healthy older adults and could benefit women receiving ESBC treatment.

This study analyzed if moderate-intensity aerobic exercise can enhance perceived cognitive function during a 6-month course of endocrine therapy in women diagnosed with ESBC.

The study included 153 postmenopausal women within two years of being diagnosed with hormone-receptor-positive ESBC. Patients were randomized to an aerobic exercise group (n=77) or a usual care group (n=76). The aerobic exercise regimen included at least 150 minutes of moderate-intensity activity per week over six months, delivered in a community setting. Certified coaches from the American College of Sports Medicine supervised the exercise intensity.

The Patient Assessment of Own Functioning Inventory (PAOFI) was employed to assess perceived cognitive function at the start and end of the intervention and for those in the usual care group. Higher scores on the PAOFI are indicative of worse perceived cognitive function. Adherence to the exercise plan was calculated as the mean percentage of actual exercise minutes compared to the recommended 150 minutes per week. The impact of aerobic exercise on perceived cognitive function was assessed using linear mixed-effects models, following an intention-to-treat approach and factoring in adherence levels.

Patients (pts) were, on average, 62.1±8.2 years of age. Most pts were white (91.5%) and well-educated (average education level of 15.9±3.0 years). Most had stage I breast cancer (64.1%). Both treatment groups were evenly matched in demographic, clinical attributes, and initial PAOFI total scores (p≥.05). As per the intention-to-treat analyses, there were no significant differences in PAOFI total scores over time between the groups. While the exercise group generally adhered to the regimen (average adherence of 101.3±6.8%), 42.7% did not fully meet the 100% adherence mark. Analysis of adherence levels showed that higher exercise adherence correlated with lower PAOFI total scores (b= -0.043; p=.040). Those in the intervention group with 100% or more adherence levels had the lowest PAOFI total scores (p=.046).

The study revealed that aerobic exercise can improve perceived cognitive function in ESBC women, primarily with adherence to the exercise intervention. Additional studies are warranted to find how aerobic exercise impacts specific aspects of perceived cognitive function.

Source: https://ons.confex.com/ons/2023/meetingapp.cgi/Paper/13564

Clinical Trial: https://classic.clinicaltrials.gov/ct2/show/NCT02793921

Sereika, S., Erickson, K., Gentry, A., Cummings, M., Rosenzweig, M.Q., Bender, C. Perceived Cognitive Functioning is Associated with Adherence to an Aerobic Exercise Intervention for Women with Early-Stage Breast Cancer.

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