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dc.creatorAraújo, N
dc.creatorSevero, M
dc.creatorLopes-Conceição, L
dc.creatorFontes, F
dc.creatorDias, T
dc.creatorBranco, M
dc.creatorMorais, S
dc.creatorCruz, VT
dc.creatorRuano, L
dc.creatorPereira, S
dc.creatorLunet, N
dc.description.abstractPurpose To identify trajectories of cognitive performance up to five years since diagnosis and their predictors, in a cohort of patients with breast cancer (BCa). Methods A total of 464 women with BCa admitted to the Portuguese Institute of Oncology, Porto, during 2012, were evaluated with the Montreal Cognitive Assessment (MoCA) before any treatment, and after one, three and five years. Probable cognitive impairment (PCI) at baseline was defined based on normative age- and education-specific reference values. Mclust was used to define MoCA trajectories. Receiver Operating Characteristic curves were used to assess the predictive accuracy for cognitive trajectories. Results Two trajectories were identified, one with higher scores and increasing overtime, and the other, including 25.9% of the participants, showing a continuous decline. To further characterize each trajectory, participants were also classified as scoring above or below the median baseline MoCA scores. This resulted in four groups: 1) highest baseline scores, stable overtime (0.0% with PCI); 2) lowest baseline scores (29.5% with PCI); 3) mid-range scores at baseline, increasing overtime (10.5% with PCI); 4) mid-range scores at baseline, decreasing overtime (0.0% with PCI). Adding the change in MoCA during the first year to baseline variables significantly increased the accuracy to predict the downward trajectory (area under the curve [AUC] = 0.732 vs. AUC = 0.841, P < 0.001). Conclusion Four groups of patients with BCa with different cognitive performance trends were identified. The assessment of cognitive performance before treatments and after one year allows for the identification of patients more likely to have cognitive decline in the long term.
dc.description.sponsorshipThis study was funded by FEDER through the Operational Programme Competitiveness and Internationalization, and national funding from the Foundation for Science and Technology – FCT (Portuguese Ministry of Science, Technology and Higher Education), under the project “A five-year prospective cohort study on the neurological complications of breast cancer: frequency and impact in patient reported outcomes” (POCI-01-0145-FEDER-016867; ref. PTDC/DTP-EPI/7183/2014), and from national funding from FCT under the Unidade de Investigação em Epidemiologia - Instituto de Saúde Pública da Universidade do Porto (info:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UIDB/04750/2020/PT). LLC and SM were also funded under the scope of the project “NEON-PC - Neuro-oncological complications of prostate cancer: longitudinal study of cognitive decline” (POCI01-0145-FEDER-032358; ref. PTDC/SAU-EPI/32358/2017). Individual grants attributed to NA (SFRH/BD/119390/2016) and FF (SFRH/BD/92630/2013) were funded by FCT and the ‘Programa Operacional Capital Humano’ (POCH/FSE). Data management activities up to the first year of follow-up were supported by the Chair on Pain Medicine of the Faculty of Medicine, University of Porto and by the Grünenthal Foundation—Portugal.
dc.relationinfo:eu-repo/grantAgreement/FCT/9471 - RIDTI/PTDC/SAU-EPI/32358/2017/PT
dc.relationinfo:eu-repo/grantAgreement/FCT/9471 - RIDTI/PTDC/DTP-EPI/7183/2014/PT
dc.relation.ispartofBreast. 2021 Aug;58:130-137
dc.subjectCognitive trajectory
dc.subjectNeurocognitive disorders
dc.subjectBreast neoplasms
dc.subjectLongitudinal studies
dc.titleTrajectories of cognitive performance over five years in a prospective cohort of patients with breast cancer (NEON-BC)
dc.typeArtigo em Revista Científica Internacional
dc.contributor.uportoInstituto de Saúde Pública da Universidade do Porto
Appears in Collections:ISPUP - Artigo em Revista Científica Internacional

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