Cognitive complaints and their associations with role functioning limitations among adolescent and young adult cancer survivors in Hong Kong.
In a multicenter cross-sectional study of 421 Hong Kong AYA cancer survivors, cognitive-complaint phenotypes—particularly global complaints—were associated with substantially higher odds of limitations in work/school and home duties.
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In a multicenter cross-sectional study of 421 Hong Kong AYA cancer survivors, cognitive-complaint phenotypes—particularly global complaints—were associated with substantially higher odds of limitations in work/school and home duties.
Research significance
The study provides observational evidence that cognitive-complaint phenotyping identifies survivors with greater role-functioning limitations; it may therefore support a hypothesis that phenotype-guided screening and referral to cognitive or rehabilitative support could improve functioning, but no intervention or treatment benefit was tested.
Source abstract
OBJECTIVE: Cognitive problems may be associated with role functioning in adolescent and young adult (AYA) cancer survivors. This study aimed to characterize the prevalence and phenotypes of cognitive complaints and examine their associations with role functioning limitations in Chinese AYA cancer survivors. METHODS: This multicenter cross-sectional study included AYA cancer survivors (diagnosed at 15-39 years). The participants' cognitive complaints were collected using the Childhood Cancer Survivor Study-Neurocognitive Questionnaire (CCSS-NCQ). Role functioning in family, leisure, and work/school was assessed using the Life Functioning Questionnaire. Patterns of cognitive complaints across the four CCSS-NCQ domains were determined using latent class analysis (LCA). Multivariable logistic regression was used to investigate the association between phenotypes of cognitive complaints and role functioning limitations, adjusting for clinically relevant factors. RESULTS: Overall, 421 AYA cancer survivors (female: 59.6%, mean age: 31.51 ± 8.35 years) were recruited. With reference to age- and sex-adjusted reference scores derived from community controls, survivors reported cognitive complaints in task efficiency (23.5%), emotional regulation (24.7%), organization (20.2%), and memory (18.1%). The LCA identified three phenotypes of cognitive complaints (Class 1: no/mild complaints; Class 2: complaints in higher-order thinking; Class 3: complaints in global cognition). Compared with the "no/mild complaints" class, the "complaints in global cognition" class had higher odds of role functioning limitations in duties at work/school (OR = 5.43; 95% CI: 1.87-15.83) and duties at home (OR = 7.81; 95% CI: 3.49-17.48). CONCLUSIONS: These findings suggest that phenotyping cognitive complaints may help characterize patterns of role functioning limitations in AYA cancer survivors.