# CHEMOBRAIN: Cognitive Deficits and Quality of Life in Chemotherapy Patients—Preliminary Assessment and Proposal for an Early Intervention Model

## TL;DR

This study shows that chemotherapy patients experience early cognitive decline linked to reduced quality of life, suggesting early assessments and interventions could help.

## Contribution

The study proposes an early intervention model based on self-reported cognitive changes to predict and mitigate quality of life decline during chemotherapy.

## Key findings

- Cognitive functioning declines progressively during the first two months of chemotherapy.
- Early self-reported cognitive changes predict later quality of life decline.
- A significant correlation exists between perceived cognitive abilities and quality of life.

## Abstract

Chemotherapy can cause cognitive decline, known as cancer-related cognitive impairment (CRCI), affecting memory, attention, processing speed, and executive functions. This research was conducted to better understand how cognitive difficulties arise during the first weeks of chemotherapy and how they impact daily life. Forty patients aged 18–64 completed a questionnaire (FACT-Cog v.3) at the start of treatment and during the following two months to report their own experiences with memory, attention, and mental clarity. We observed a gradual decline in how patients perceived their cognitive functioning, which was closely linked to a worsening quality of life. Importantly, these early self-reported changes were able to predicted subsequent declines. This suggests that simple, early assessments could help identify patients who might benefit from timely support. Our findings encourage the development of early intervention programs to maintain cognitive well-being and improve the overall experience of patients undergoing chemotherapy.

Background/Objectives: Chemotherapy can negatively affect cognitive functioning through direct and indirect mechanisms, with 15–50% of patients experiencing a decline that impacts quality of life. While neurocognitive tests are the main assessment tool, self-reported measures provide valuable additional insights. The aim of this study was to evaluate the cognitive decline of patients during the early stages of chemotherapy treatment and its impact on their quality of life, as well as to outline future perspectives for an early intervention model. Materials and Methods: This prospective longitudinal study was conducted on 40 patients aged 18 to 64 years. Data were collected using the FACT-Cog v.3 questionnaire, administered at the beginning of the first chemotherapy cycle (T0), and then again after approximately 3–4 weeks (T1) and 6–8 weeks (T2). Results: The data show a progressive decline in perceived cognitive abilities (PCI: 72.10 → 64.43; PCA: 25.70 → 20.90) and overall quality of life (9.73 → 8.75) from T0 to T2. A significant positive correlation was found between perceived cognitive abilities and quality of life, supporting the link between cognitive decline and quality of life. Questionnaire variables reliably predicted changes in quality of life two months after chemotherapy [F(4, 35) = 3.91, p = 0.01]. Conclusions: The findings show a decline in quality of life as chemotherapy progresses. However, this decline can be predicted from the second month of treatment using the FACT-Cog v.3 questionnaire. The findings further highlight even more the value of integrating early empowerment, rehabilitative and psychoeducational programs to mitigate cognitive decline and improve quality of life.