Physical activity and cognitive function: A comparison of rural and urban breast cancer survivors

• Published in: PloS one 2023-04, Vol.18 (4), p.e0284189-e0284189
• Main Authors: Page, Lindsey L, Kahn, Christina J, Severson, Joan, Kramer, Arthur F, McAuley, Edward, Ehlers, Diane K
• Format: Article
• Language: English
• Subjects: Accelerometers; Age; Aged; Alzheimer's disease; Alzheimers disease; Analysis; Anxiety; Biology and Life Sciences; Breast cancer; Breast Neoplasms - psychology; Cancer; Cancer survivors; Cancer Survivors - psychology; Cancer therapies; Care and treatment; Cognition; Cognition & reasoning; Cognitive ability; Cognitive tasks; Comorbidity; Comparative analysis; Correlation; Exercise; Exercise - psychology; Fatigue; Female; Health aspects; Humans; Information processing; Medicine and Health Sciences; Memory; Memory Disorders - complications; Mental depression; Mental task performance; Middle Aged; Multivariate analysis; Older people; Oncology, Experimental; Patient outcomes; Physical activity; Physical fitness; Quality of life; Regression analysis; Regression models; Rural areas; Self report; Short term memory; Sleep; Spatial memory; Suburban areas; Survivors; Womens health
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0284189

Increasing evidence suggests rural breast cancer survivors (BCS) may experience greater burden in symptoms known to be associated with cancer-associated cognitive decline (CACD). Yet, little is known about CACD in rural BCS. This study (1) examined differences in cognitive function, moderate-to-vigorous physical activity (MVPA), and other CACD correlates and (2) tested the effects of MVPA on cognitive function in rural versus urban BCS. Rural and urban BCS (N = 80), matched on age, education, and time since diagnosis from a larger study, completed cognitive tasks assessing processing speed (Trails-B, Mazes, Task-Switch) and working memory (spatial working memory) and questionnaires assessing subjective memory impairment (SMI), MVPA, and CACD correlates (i.e., sleep quality, fatigue, anxiety/depression). Some participants (n = 62) wore an accelerometer to objectively estimate MVPA. Multiple linear regression and multivariate analysis of covariance were used to test study aims. Rural BCS (n = 40, M = 61.1±8.4 years-old) performed significantly slower on Trails-B (p0.28). Regression models did not reveal a significant interaction between MVPA and cognitive performance (all p>0.1); however, estimated marginal means models indicated that the effect of MVPA on processing speed was evident only among rural BCS (Trails-B, p = 0.04; Mazes, p = 0.03). Findings suggest rural BCS may suffer greater CACD and engage in less MVPA. Additional research is warranted to further examine CACD and more effectively promote MVPA in rural BCS.