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Interventions promoting cognitive function in patients experiencing cancer related cognitive impairment: A systematic review

Journal

PSYCHO-ONCOLOGY
Volume 32, Issue 2, Pages 214-228

Publisher

WILEY
DOI: 10.1002/pon.6073

Keywords

antineoplastic agents; cancer; chemotherapy-related cognitive impairment; cognitive dysfunction; memory; oncology; survivorship; systematic review

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This study examined interventions used to enhance cognitive function in patients with cancer-related cognitive impairment. A total of 31 studies were analyzed and various interventions were identified, including integrative/complementary, cognitive behavioral therapy and compensatory strategies, exercise, psychoeducational/psychosocial, brain-training, and pharmacological approaches. However, the measurement of outcomes was inconsistent, making it difficult to draw definitive conclusions. Future research should prioritize the use of standardized measures to evaluate the effectiveness of interventions.
ObjectiveTo examine the effect of interventions used to enhance cognitive function in patients experiencing cancer-related cognitive impairment. MethodsStudies including adults with a non-metastatic cancer who have received chemotherapy as part of their treatment and who have undergone interventions targeting cancer-related cognitive impairment were included. Studies involving patients with metastatic cancer and pre-existing cognitive deficits were excluded. Academic Search Complete, CINAHL Plus with full text, MEDLINE, Education Full Text, PsycARTICLES, PsycINFO, and ERIC were searched for studies published between January 2011 and September 2022. Data extraction and quality appraisal were conducted by two authors and cross-checked by the review team. Quality appraisal was conducted using 12 items from the Mixed Methods Appraisal Tool. Findings were presented narratively without meta-analysis. ResultsThirty-one studies were included. Interventions were categorised as integrative/complementary, cognitive behavioural therapy and compensatory strategies, exercise, psychoeducational/psychosocial, brain-training, and pharmacological. Over 100 instruments were identified, including the Functional Assessment of Cancer Therapy-Cognitive, Trail Making Tests-A and B, and instruments measuring secondary outcomes, including depression. Instruments often measured attention and concentration, language, memory, executive function, and/or patient-reported outcomes. Improvements were reported, with most studies measuring some or various aspects of cognitive functioning and very few studies measuring all domains of cognitive functioning, making it difficult to draw definitive conclusions about effectiveness. ConclusionsVarious interventions are available to treat cancer-related cognitive impairment. Outcome measurement was inconsistent and future research should prioritise using standardised measures. Current evidence, whilst not being definitive, suggests that certain interventions show greater promise than others, including cognitive behavioural therapy and brain training.

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