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Cancer. 2018 Nov 26. doi: 10.1002/cncr.31777. [Epub ahead of print]

Cognitive performance in survivors of breast cancer and markers of biological aging.

Carroll JE1,2,3,4, Van Dyk K2,4, Bower JE1,2,3,4,5, Scuric Z6,7,8,9, Petersen L4, Schiestl R6,7,8,9, Irwin MR1,2,3,4, Ganz PA4,6.

Author information

1
Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California.
2
Department of Psychiatry and Biobehavioral Science, Semel Institute for Neuroscience and Human Behavior, University of California at Los Angeles, Los Angeles, California.
3
Cousins Center for Psychoneuroimmunology, Los Angeles, California.
4
Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.
5
Department of Psychology, University of California at Los Angeles, Los Angeles, California.
6
Fielding School of Public Health, University of California at Los Angeles, Los Angeles, California.
7
Department of Pathology, University of California at Los Angeles, Los Angeles, California.
8
Department of Environmental Health, University of California at Los Angeles, Los Angeles, California.
9
University of California at Los Angeles School of Public Health, Los Angeles, California.

Abstract

BACKGROUND:

Biological aging pathways accelerated by cancer treatments may be a mechanism for cognitive impairment in cancer survivors. The goal of the current study was to examine whether indicators of biological aging, namely elevated levels of DNA damage, reduced telomerase enzymatic activity, and shorter peripheral blood mononuclear cell (PBMC) telomere length (TL) would be related to cognitive function in a cohort of survivors of breast cancer.

METHODS:

The authors evaluated a cross-sectional sample of 94 women aged 36 to 69 years who were treated for early-stage breast cancer 3 to 6 years previously. Leukocyte DNA damage, PBMC telomerase enzymatic activity, PBMC TL, and the inflammatory marker soluble tumor necrosis factor receptor II (sTNF-RII) were determined from blood samples. Cognitive function was assessed using a neuropsychological test battery and self-report. Linear regression models examined the relationship between biological aging predictors and cognitive outcomes.

RESULTS:

Both higher DNA damage and lower telomerase were found to be statistically significantly related to lower executive function scores adjusting for age, body mass index, race, years from treatment, and intelligence score (standardized coefficients [B], -0.23 and 0.30; all P values <.05). In addition, lower telomerase activity was associated with worse attention and motor speed scores (B values, 0.30 and 0.24; P &lt;.05). sTNF-RII and TL were found to be unrelated to any of the neurocognitive domains.

CONCLUSIONS:

The results of the current study suggest a significant association between measures of biological aging and objective measures of cognitive performance in survivors of breast cancer. Future prospective studies are needed to confirm a causal role of biological aging as a driver of declines in cognitive function after cancer treatment.

KEYWORDS:

DNA damage; biological aging; breast cancer; cognition; executive function; survivors; telomerase

PMID:
30474160
DOI:
10.1002/cncr.31777

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