INS NYC 2024 Program

Poster	Poster Session 08 Program Schedule 02/16/2024 01:45 pm - 03:00 pm Room: Shubert Complex (Posters 1-60) Poster Session 08: Cognition \| Cognitive Reserve Variables Final Abstract #27 The Association of Menopause Symptoms and Perceived Cognitive Function Among Breast Cancer Survivors on Endocrine Therapy Genifer Goldsmith, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States Lucy Wall, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States Hadine Joffe, Connors Center for Women's Health and Gender Biology, Department of Psychiatry, Brigham and Women's Hospital, Department of Psychosocial Oncology and Palliative Care, and Dana-Farber Cancer Institute, Harvard Medical School, Boston, United States Judith Carroll, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States Bookheimer Susan, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States Catherine Crespi, UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, United States Alison Burggren, Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, United States Barbara Kahn-Mills, UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, United States Laura Petersen, UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, United States Patricia Ganz, UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Department of Medicine, David Geffen School of Medicine at UCLA, Department of Health Policy & Management, UCLA-Fielding School of Public Health, Los Angeles, United States Kathleen Van Dyk, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, United States Category: Cancer Keyword 1: breast cancer Keyword 2: cognitive functioning Keyword 3: endocrine disorders Objective: Breast cancer survivors taking endocrine therapy commonly report menopause like symptoms such as hot flashes, regardless of their menopausal status at the time of treatment onset. Women in this population often endorse perceived cognitive difficulties linked to endocrine therapy. Menopause symptoms have been associated with self-reported cognitive problems in studies of the effects of natural menopause in women without cancer. Despite these links, there has been little investigation of the association between menopause symptoms and cognitive function among women on anti-estrogen endocrine therapy for breast cancer. This preliminary study examined the relationship between patient reported menopause symptoms and perceived cognitive difficulties in a sample of breast cancer survivors currently taking endocrine therapy. Participants and Methods: Breast cancer survivors diagnosed 1.5-5 years prior and currently taking endocrine therapy were screened for dementia and then completed online questionnaires that included Menopause Rating Scale (MRS), The Hot Flash Related Daily Interference Scale (HFRDIS), and Functional Assessment of Cancer Therapy – Cognition, Perceived Cognitive Impairment (FACT-Cog PCI), and clinical/demographic information. We conducted exploratory multivariable models examining MRS and HFRDIS as predictors of FACT-Cog PCI scores, controlling for age and time on endocrine therapy. Results: Fifty-nine women, age 35 –67 (mean = 52.71, SD = 7.66) were recruited, predominantly White (84%) or Asian (13%). Participants were taking endocrine therapy for 32 months on average (range = 5-58, SD = 12.85). Most women were pre-menopausal at the time of their breast cancer diagnosis (n = 41, 70%). MRS Total scores were similar to published averages for menopausal women among both women who were pre-menopausal or post-menopausal and the time of diagnosis and not significantly different from each other: mean = 12.2, SD = 6.79; mean = 10.11, SD = 5.23, respectively. Mean FACT-Cog PCI scores were 61.35, SD = 14.50 and not different between menopausal groups. Most women (93%) reported good treatment adherence. Multivariable models of the FACT-Cog PCI indicated that MRS was a significant predictor (B = -1.23, p <.01), F(3,58) – 7.45, p <.01, R² = .29. A separate model also indicated that HFRDIS was a significant predictor (B = -.38, p <.01), F(3,58) = 4.11, p=.01, R² = .18. Age and time on endocrine therapy did not significantly contribute to any model. Sensitivity analyses within menopausal group suggested that the relationship between MRS Total and FACT-Cog PCI was largely driven by women who were pre-menopausal at the time of their breast cancer diagnosis (r = -.59, p<.01) compared to a weaker relationship among post-menopausal women at the time of diagnosis (r = -.24, p = .34). Relationships between HFRDIS and the FACT-Cog PCI were similar within pre-menopausal (r = -.34, p = .03) and post-menopausal (r = -.62, p<.01) groups. Conclusions: Menopausal symptoms are an important factor to consider when assessing or investigating the perceived cognitive effects of endocrine therapy. Notably, the contribution of menopause symptoms to self-report cognitive difficulties among women with breast cancer on endocrine therapy may be particularly prominent for those women who were pre-menopausal at the time of diagnosis.

Poster

02/16/2024
01:45 pm - 03:00 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 08: Cognition | Cognitive Reserve Variables

Final Abstract #27

The Association of Menopause Symptoms and Perceived Cognitive Function Among Breast Cancer Survivors on Endocrine Therapy

Genifer Goldsmith, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States
Lucy Wall, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States
Hadine Joffe, Connors Center for Women's Health and Gender Biology, Department of Psychiatry, Brigham and Women's Hospital, Department of Psychosocial Oncology and Palliative Care, and Dana-Farber Cancer Institute, Harvard Medical School, Boston, United States
Judith Carroll, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States
Bookheimer Susan, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, United States
Catherine Crespi, UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, United States
Alison Burggren, Robert and Beverly Lewis Center for Neuroimaging, University of Oregon, Eugene, United States
Barbara Kahn-Mills, UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, United States
Laura Petersen, UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, United States
Patricia Ganz, UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles; Department of Medicine, David Geffen School of Medicine at UCLA, Department of Health Policy & Management, UCLA-Fielding School of Public Health, Los Angeles, United States
Kathleen Van Dyk, Semel Institute and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles; UCLA Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, United States

Category: Cancer

Keyword 1: breast cancer
Keyword 2: cognitive functioning
Keyword 3: endocrine disorders

Objective:

Breast cancer survivors taking endocrine therapy commonly report menopause like symptoms such as hot flashes, regardless of their menopausal status at the time of treatment onset. Women in this population often endorse perceived cognitive difficulties linked to endocrine therapy. Menopause symptoms have been associated with self-reported cognitive problems in studies of the effects of natural menopause in women without cancer. Despite these links, there has been little investigation of the association between menopause symptoms and cognitive function among women on anti-estrogen endocrine therapy for breast cancer. This preliminary study examined the relationship between patient reported menopause symptoms and perceived cognitive difficulties in a sample of breast cancer survivors currently taking endocrine therapy.

Participants and Methods:

Breast cancer survivors diagnosed 1.5-5 years prior and currently taking endocrine therapy were screened for dementia and then completed online questionnaires that included Menopause Rating Scale (MRS), The Hot Flash Related Daily Interference Scale (HFRDIS), and Functional Assessment of Cancer Therapy – Cognition, Perceived Cognitive Impairment (FACT-Cog PCI), and clinical/demographic information. We conducted exploratory multivariable models examining MRS and HFRDIS as predictors of FACT-Cog PCI scores, controlling for age and time on endocrine therapy.

Results:

Fifty-nine women, age 35 –67 (mean = 52.71, SD = 7.66) were recruited, predominantly White (84%) or Asian (13%). Participants were taking endocrine therapy for 32 months on average (range = 5-58, SD = 12.85). Most women were pre-menopausal at the time of their breast cancer diagnosis (n = 41, 70%). MRS Total scores were similar to published averages for menopausal women among both women who were pre-menopausal or post-menopausal and the time of diagnosis and not significantly different from each other: mean = 12.2, SD = 6.79; mean = 10.11, SD = 5.23, respectively. Mean FACT-Cog PCI scores were 61.35, SD = 14.50 and not different between menopausal groups. Most women (93%) reported good treatment adherence.

Multivariable models of the FACT-Cog PCI indicated that MRS was a significant predictor (B = -1.23, p <.01), F(3,58) – 7.45, p <.01, R² = .29. A separate model also indicated that HFRDIS was a significant predictor (B = -.38, p <.01), F(3,58) = 4.11, p=.01, R² = .18. Age and time on endocrine therapy did not significantly contribute to any model. Sensitivity analyses within menopausal group suggested that the relationship between MRS Total and FACT-Cog PCI was largely driven by women who were pre-menopausal at the time of their breast cancer diagnosis (r = -.59, p<.01) compared to a weaker relationship among post-menopausal women at the time of diagnosis (r = -.24, p = .34). Relationships between HFRDIS and the FACT-Cog PCI were similar within pre-menopausal (r = -.34, p = .03) and post-menopausal (r = -.62, p<.01) groups.

Conclusions:

Menopausal symptoms are an important factor to consider when assessing or investigating the perceived cognitive effects of endocrine therapy. Notably, the contribution of menopause symptoms to self-report cognitive difficulties among women with breast cancer on endocrine therapy may be particularly prominent for those women who were pre-menopausal at the time of diagnosis.