Assessment of chemotherapy-induced cognitive impairment in cancer patients
DOI:
https://doi.org/10.18203/2320-6012.ijrms20263540Keywords:
Chemotherapy-induced cognitive impairment, Cancer, FACT-Cog, Cognitive function, ChemotherapyAbstract
Background: Chemotherapy-induced cognitive impairment (CICI) is a well-established side-effect of cancer treatment, which can impact memory, attention, executive function and quality of life. There have been reports of cognitive impairment in chemotherapy-treated patients, but there is limited data in the Indian population. This study was conducted to assess the prevalence of CICI and identify factors associated with cognitive impairment among patients undergoing chemotherapy.
Methods: A cross-sectional observational study was performed among 160 adult cancer patients receiving chemotherapy treatment at a tertiary care center. The functional assessment of cancer therapy – cognitive function (FACT-Cog, version 3) questionnaire was used to measure cognitive function. A structured case record form was used to gather the demographic and clinical information. Descriptive statistics, correlation analysis and multivariable logistic regression were used for statistical analysis to find independent predictors of cognitive impairment.
Results: Among 160 participants, 57 (35.6%) had chemotherapy induced cognitive impairment. Cognitive function was significantly associated with advanced cancer stage and number of chemotherapy cycles and was an independent predictor of cognitive impairment in multivariable analyses. Type 2 diabetes mellitus was associated with lower odds of cognitive impairment, although this finding requires further investigation.
Conclusions: Cognitive impairment was common among patients who were receiving chemotherapy. Greater treatment exposure and advanced disease stage were independently associated with cognitive impairment, highlighting the importance of routine cognitive assessment during cancer treatment. Further prospective multicenter studies are needed to confirm these findings and improve the management of chemotherapy-induced cognitive impairment.
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Zafar A, Khatoon S, Khan MJ, Abu J, Naeem A. Advancements and limitations in traditional anti-cancer therapies: a comprehensive review of surgery, chemotherapy, radiation therapy, and hormonal therapy. Discov Oncol. 2025;16(1):607. DOI: https://doi.org/10.1007/s12672-025-02198-8
Das A, Ranadive N, Kinra M, Nampoothiri M, Arora D, Mudgal J. An Overview on Chemotherapy-induced Cognitive Impairment and Potential Role of Antidepressants. Curr Neuropharmacol. 2020;18(9):838-51. DOI: https://doi.org/10.2174/1570159X18666200221113842
Neth BJ, Schagen SB, Wefel JS. Cancer treatment-related cognitive impairment. Neurooncol Adv. 2026;8(Suppl 5):37-57. DOI: https://doi.org/10.1093/noajnl/vdag064
Cheung YT, Ho MH, Fardell J, Vardy JL. Assessment and management of cancer-related cognitive impairment. Am Soc Clin Oncol Educ Book. 2026;46(3):e517676. DOI: https://doi.org/10.1200/EDBK-26-517676
Fleming B, Edison P, Kenny L. Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management. BMJ. 2023;380:e071726. DOI: https://doi.org/10.1136/bmj-2022-071726
Van Dyk K, Crespi CM, Petersen L, Ganz PA. Identifying cancer-related cognitive impairment using the FACT-Cog Perceived Cognitive Impairment. JNCI Cancer Spectr. 2020;4(1):pkz099. DOI: https://doi.org/10.1093/jncics/pkz099
Singh P, Leon C, Kaur S, Batra A, Tayade P, Prakash MS, et al. Acute and long-term effects of chemotherapy on cognitive function among Indian breast cancer patients. Ecancermedicalscience. 2025;19:1856. DOI: https://doi.org/10.3332/ecancer.2025.1856
Kim HJ, Jung SO, Kim H, Abraham I. Systematic review of longitudinal studies on chemotherapy-associated subjective cognitive impairment in cancer patients. Psychooncology. 2020;29(4):617-31. DOI: https://doi.org/10.1002/pon.5339
Janelsins MC, Heckler CE, Peppone LJ, Ahles TA, Mohile SG, Mustian KM, et al. Longitudinal Trajectory and Characterization of Cancer-Related Cognitive Impairment in a Nationwide Cohort Study. J Clin Oncol. 2018;36(32):JCO2018786624. DOI: https://doi.org/10.1200/JCO.2018.78.6624
Brezden CB, Phillips KA, Abdolell M, Bunston T, Tannock IF. Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol. 2000;18(14):2695-701. DOI: https://doi.org/10.1200/JCO.2000.18.14.2695
Whittaker AL, George RP, O'Malley L. Prevalence of cognitive impairment following chemotherapy treatment for breast cancer: a systematic review and meta-analysis. Sci Rep. 2022;12(1):2135. DOI: https://doi.org/10.1038/s41598-022-05682-1
Maurer GS, Clayton ZS. Anthracycline chemotherapy, vascular dysfunction and cognitive impairment: burgeoning topics and future directions. Future Cardiol. 2023;19(11):547-66. DOI: https://doi.org/10.2217/fca-2022-0086
Durán-Gómez N, López-Jurado CF, Nadal-Delgado M, Pérez-Civantos D, Guerrero-Martín J, Cáceres MC. Chemotherapy-Related Cognitive Impairment in Patients with Breast Cancer Based on Functional Assessment and NIRS Analysis. J Clin Med. 2022;11(9):2363. DOI: https://doi.org/10.3390/jcm11092363
Root JC, Zhou X, Ahn J, Small BJ, Zhai W, Bethea T, et al. Association of markers of tumor aggressivity and cognition in women with breast cancer before adjuvant treatment: The Thinking and Living with Cancer Study. Breast Cancer Res Treat. 2022;194(2):413-22. DOI: https://doi.org/10.1007/s10549-022-06623-2
Areosa Sastre A, Vernooij RW, González-Colaço Harmand M, Martínez G. Effect of the treatment of Type 2 diabetes mellitus on the development of cognitive impairment and dementia. Cochrane Database Syst Rev. 2017;6(6):CD003804. DOI: https://doi.org/10.1002/14651858.CD003804.pub2
Tabesh M, Sacre JW, Mehta K, Chen L, Sajjadi SF, Magliano DJ, et al. Associations of glycaemia-related risk factors with dementia and cognitive decline in individuals with type 2 diabetes: A systematic review and meta-analysis. Diabet Med. 2025;42:e70123. DOI: https://doi.org/10.1111/dme.70123
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Copyright (c) 2026 VAISHNAVI PRASANNAN, Joseph Joseph , Sibu Sah Teli, Simab Akhtar
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