# Early Identification of Mild Cognitive Impairment in Person with Cancer Undergoing Chemotherapy: Associations with Anxiety, Sleep Disturbance and Depression

## TL;DR

This study finds that cancer patients undergoing chemotherapy with poor sleep and anxiety show worse cognitive performance, suggesting early multidimensional assessments can help manage cognitive issues.

## Contribution

The study identifies sleep disturbances and aging as key factors in cognitive decline among cancer patients, emphasizing the need for early multidimensional assessments.

## Key findings

- Poor sleep quality and older age are strongly linked to lower cognitive performance in cancer patients undergoing chemotherapy.
- Cognitive performance correlates negatively with anxiety/depression and sleep disturbances.
- Age is significantly associated with cognitive decline and psychological symptoms in cancer patients.

## Abstract

What are the main findings?
Cancer-Related Cognitive Impairment (CRCI) is influenced by multiple factors, including psychological distress, sleep disturbances, and aging.Poor sleep quality and older age were strongly associated with lower cognitive performance in cancer patients undergoing chemotherapy.

Cancer-Related Cognitive Impairment (CRCI) is influenced by multiple factors, including psychological distress, sleep disturbances, and aging.

Poor sleep quality and older age were strongly associated with lower cognitive performance in cancer patients undergoing chemotherapy.

What are the implications of the main findings?
Early, multidimensional assessment combining cognitive, emotional, and sleep evaluations is essential to detect CRCI in cancer patients.Timely identification can guide interventions to improve quality of life and treatment outcomes, particularly in older adults.

Early, multidimensional assessment combining cognitive, emotional, and sleep evaluations is essential to detect CRCI in cancer patients.

Timely identification can guide interventions to improve quality of life and treatment outcomes, particularly in older adults.

Background/Objectives: Cancer-Related Cognitive Impairment (CRCI) is a frequent and significant complication in cancer patients, involving deficits in memory, attention, and executive functions. Its multifactorial origin includes effects of oncological treatments, psychological factors, and aging—particularly impacting older adults. Early detection through thorough cognitive and psychological evaluation is crucial to optimizing management and maintaining quality of life. Methods: This cross-sectional descriptive-correlational study employed a non-probabilistic convenience sampling technique to recruit cancer patients receiving chemotherapy at the Complejo Asistencial Universitario de Salamanca (Spain) between January 2023 and February 2025. Participants were assessed using validated instruments measuring cognitive function (CFRT), subjective memory failures (MFE-30), anxiety and depression (HADS), and sleep quality (PSQI). Statistical analyses included correlation tests, analysis of variance (ANOVA), and multivariable linear regression models to examine associations among cognitive, psychological, and sleep-related variables. Statistical analyses were performed using IBM SPSS Statistics version 29.0 (IBM Corp., Armonk, NY, USA). Results: Participants (mean age 63.18 years) showed a notable presence of subjective memory complaints and mild anxiety/depression symptoms. Cognitive performance correlated negatively with anxiety/depression (ρ = −0.146, p < 0.05) and sleep disturbances (ρ = −0.583, p < 0.001). Sleep quality worsened with increasing age (ρ = 0.583, p < 0.001), and age itself showed significant associations with cognitive decline and psychological symptoms. No significant link was found between anxiety/depression and sleep quality. Conclusions: Findings confirm CRCI as a multifactorial condition influenced by psychological distress, sleep quality, and aging. The study highlights the importance of early, multidimensional cognitive assessment, especially in older patients, to enable timely interventions. Integrating objective and subjective measures alongside emotional and sleep evaluations enhances understanding and management of CRCI, ultimately improving patient outcomes and quality of life.