Associations of functional, psychosocial, medical, and socio-demographic factors with cognitive screening in chemotherapy naive patients with breast cancer

Objective To describe associations of functional, psychosocial, medical, and socio-demographic factors with performance on a cognitive screening test in chemotherapy naive patients with breast cancer. Methods Women with breast cancer were recruited between 2009 and 2018. The Blessed Orientation Memory Concentration Test (BOMC) was administered prior to chemotherapy. Associations between baseline BOMC and functional (Karnofsky Self-Reported Performance Rating Scale (KPS), Time Up and Go Test (TUG), Medical Outcomes Study (MOS) Physical Function, Instrumental Activities of Daily Living (IADL)), psychosocial (Mental Health Inventory-13, MOS Social Activity Limitation and Social Support Survey), medical, and socio-demographic variables were assessed using linear regression analysis. Results In a sample of 331 women with breast cancer, the mean age was 65.2 years and 68.6% were 65 and older. Mean BOMC score was 3.60 on a scale from 0 (best) to 28 (worst). After controlling for demographic factors, worse BOMC screening test results were associated with KPS < 80 (P = 0.01), IADL<14 (P = 0.02), TUG >= 14 seconds (P = 0.001), worse MOS Physical Function (P = 0.0006), depressive symptoms (P = 0.04), and social activity limitations (P = 0.01). Conclusion In a sample of women with breast cancer, pre-treatment cognitive screening scores did not reveal profound cognitive impairment. BOMC screening scores were associated with multiple measures of physical function, but further research is needed to determine a clinically meaningful cut point in the BOMC for screening of cancer-related cognitive impairment.