Characterization of cancer survivors clustered by subjective and objective cognitive function scores

TL;DR

This study identifies five distinct groups of cancer survivors based on their cognitive function, helping to better understand and manage cancer-related cognitive impairment.

Contribution

The study introduces a novel clustering approach combining subjective and objective cognitive scores to classify CRCI phenotypes.

Findings

Five clusters were identified based on cognitive function scores and psychosocial factors.

Clusters 4 and 5 showed the best cognitive abilities and fewer psychoneurological symptoms.

Higher education and social support were associated with better cognitive outcomes.

Abstract

Cancer‐related cognitive impairment (CRCI) is a prevalent condition that significantly impacts the quality of life of individuals who receive cancer treatment. Clinical management of CRCI presents challenges due to the absence of a standardized assessment. This study identified clinically relevant phenotypic clusters of CRCI based on subjective and objective cognitive function scores.

In this cross‐sectional study, participants were clustered using the VARCLUS™ based on subjective cognitive impairment assessed through the PROMIS® version 1.0 short‐form subscales of cognitive abilities and cognitive concerns and the CANTAB Cambridge Cognition® scores, which included measures of visuospatial working memory capacity, visual episodic memory, new learning, working memory, executive function, and sustained attention. Each cluster's characteristics were described using demographics, physical and psychosocial factors (physical function, affect, optimism, and social support), and psychoneurological symptoms (anxiety, depression, fatigue, neuropathic pain, and sleep disturbance).

We obtained five clusters from a total of 414 participants, where 99% were female, and 93% were self‐reported white. Clusters 4 and 5 showed the highest PROMIS® cognitive abilities and the lowest measures of cognitive concern, while Clusters 1 and 2 showed the lowest cognitive abilities and the highest cognitive concerns. Clusters 4 and 5 had higher education, income, employment, and higher scores in physical function, positive affect, optimism, and social support. Additionally, individuals in these clusters were less prone to experience severe cancer‐related psychoneurological symptoms.

Our clustering approach, combining subjective and objective cognitive function information, shows promise in identifying phenotypes that hold clinical relevance for categorizing patient presentation of CRCI and facilitating individualized management strategies.

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