Relationships Between Self-Reported Physical and Cognitive Function During Anastrozole Therapy

Ceara Conley


Background: Adjuvant hormonal therapy has been shown to have negative cognitive effects in some women with breast cancer. Physical activity improves cognitive function in healthy older adults and may also benefit cognitive function in patients with cancer. Although this relationship has not been well-documented. Patient's perceptions of physical and cognitive functioning may impact their daily lives during a crucial period of cancer survivorship. Therefore, the purpose of this study was to examine the relationship between perceived cognitive function and perceived physical function in postmenopausal women with early-stage breast cancer.

Methods: Perceived cognitive and physical function were measured in 145 women before aromatase inhibitor therapy and at 6 months post-initiation of therapy. Perceived cognitive function was assessed using the Patient Assessment of Own Functioning Inventory (PAOFI). The PAOFI measures patients' perceptions of overall cognitive function, memory, language, and communication, sensorimotor, and higher level cognitive and intellectual functioning (HLCIF). Perceived physical functioning was measured using the physical and role functioning subscales of the Medical Outcomes Study Short Form 36 (version 2; SF-36) Health Survey. Descriptive statistics of the sample were run. PAOFI and SF-36 change scores were calculated by subtracting baseline scores from six month follow-up scores, and Spearman's rho was used to calculate correlations among the change scores.

Results: The average age was 62 years with some college completed. The sample was predominantly white (97%) women who were currently married or partnered (64%). Mean change scores for overall cognitive function (M=.64, SD=9.6), as well as memory (M=.29, SD=3.7) and HLCIF (M=.35, SD=3.6), were worse from before anastrozole therapy to six months after initiation of therapy. Although physical function worsened (M=-.11, SD=16), role-physical function improved (M=8.2, SD=23). We found a small but significant change in the role physical subscale of the PAOFI and total change (r=-.21, p=.014) and change in higher level cognitive and intellectual functioning (r=-.19, p=.02). As role-physical function improved, overall cognitive function and HLCIF also improved. We also found small but significant correlations between change in physical function and change in the PAOFI total score (r=-.25, p=.002), memory (r=-.25, p=.003), and HLCIF (r=-.17, p=.04). As physical function worsened, overall cognitive function, memory, and HLCIF worsened.

Conclusions: These findings suggest that, for women whose functional ability declines during the first six months of anastrozole therapy, there may be a greater difficulty with memory, higher level cognitive function, and overall cognitive function. Interventions targeted to improve physical function during the crucial period of cancer survivorship may also improve perceived cognitive function.


Breast Cancer; Perceived Cognitive Function; Physical Function

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