MCI in Irradiated Brain Tumor Survivors N McKee S Rapp D Case G Bayer P Bilodeau W Edenfield N Erickson S Falchuk J Giguere J Lawrence G Lesser M Loghin ID: 486469
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Slide1
Incidence of Mild Cognitive Impairment (MCI) inIrradiated Brain Tumor Survivors
N McKee, S Rapp, D Case, G Bayer, P
Bilodeau
, W
Edenfield
, N Erickson, S
Falchuk
,
J
Giguere
, J Lawrence, G Lesser,
M
Loghin
, D Moore, M
Naughton
, B Needles, A
Peiffer
,
J
Piephoff
, V
Stieber
, and E Shaw
For the Wake Forest NCI Community Oncology Research Base Program
Winston-Salem, NCSlide2
BackgrounndThe nomenclature for treatment-induced cognitive dysfunction in cancer patients has been colloquial, e.g., “chemobrain” and “cancer-associated cognitive syndrome.” In contrast, standardized terminology has been well documented and validated in dementia research and clinical care. Mild Cognitive Impairment (MCI)
is the prodromal stage of subsequent stages of Alzheimer’s disease (i.e., early, middle, and late stage dementia).Slide3
National Institute of Aging/ Alzheimer’s Association Criteria for MCIa subjective cognitive complaint demonstrated
cognitive deficit (1.5 SD worse than normative group) in at least 1 major cognitive domain on standardized measures of cognitive performance
cognitive
deficit does not cause significant functional impairment in basic everyday
abilities
must
rule out reversible medical or psychiatric causes for deficits and
impairments
not
dementedSlide4
Materials/MethodsFrom 2/08-12/11, 198 adult primary/metastatic brain tumor and/or PCI survivors ≥ 6 months post partial or whole-brain radiation therapy (≥30 Gray) participated in a Wake Forest CCOP Research Base clinical trial in which they were randomly assigned to receive 6 months of donepezil or placebo (Rapp et al, ASCO Proceedings, 2013). Baseline self-reported cognitive symptoms were assessed with the FACT-Brain; cognitive function was assessed with a cognitive battery of validated instruments assessing memory, attention, executive function, language
and
visuospatial
skills.Slide5
Results: 74% patients met criteria for MCI (vs. 7-19% in general population of older adults)Slide6
ConclusionsThe 74% incidence of MCI in this group of irradiated brain tumor survivors (median age 55 years) was much higher than the general population (median age >75 years).Oncologists should
consider
adopting the
NIA/AA chronology of MCI
early dementia middle
dementia
late dementia
in
cancer
patients with
treatment-induced
cognitive
sequelae
to
facilitate
future research in
the
etiology of, risk factors for,
and treatment
of MCI and dementia in
cancer
survivors.