Self‐endorsed cognitive problems versus objectively assessed cognitive impairment in blood or bone marrow transplantation recipients: A longitudinal study

Background Cognitive impairment in survivors of blood or bone marrow transplantation (BMT) is well documented. However, to the authors' knowledge, the clinical relevance of self‐endorsed cognitive problems and their relation to objectively assessed cognitive impairment is not known. Methods The...

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Published in:Cancer 2020-05, Vol.126 (10), p.2174-2182
Main Authors: Murdaugh, Donna L., Bosworth, Alysia, Patel, Sunita K., Sharafeldin, Noha, Chen, Yanjun, Francisco, Liton, Forman, Stephen J., Wong, F. Lennie, Bhatia, Smita
Format: Article
Language:English
Subjects:
Adult
Aged
Blood
blood or bone marrow transplantation (BMT)
Blood Transfusion
Bone marrow
Bone marrow transplantation
Bone Marrow Transplantation - adverse effects
cancer survivors
Case-Control Studies
Cognitive ability
Cognitive Dysfunction - diagnosis
Cognitive Dysfunction - etiology
cognitive impairment
Correlation analysis
Demographic variables
Endorsements
Female
Humans
Impairment
longitudinal
Longitudinal Studies
Male
Middle Aged
Multivariable control
Neuropsychological Tests
Oncology
return to work
Self Report
Statistical analysis
Stem cell transplantation
Subpopulations
Transfusion Reaction - psychology
Transplantation
Young Adult
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cited_by cdi_FETCH-LOGICAL-c4483-2bc83f2bfd5f9987d549780d3674d5cf9afe4400f6dc1e9e01e2cf2b300bfc573
cites cdi_FETCH-LOGICAL-c4483-2bc83f2bfd5f9987d549780d3674d5cf9afe4400f6dc1e9e01e2cf2b300bfc573
container_end_page 2182
container_issue 10
container_start_page 2174
container_title Cancer
container_volume 126
creator Murdaugh, Donna L.
Bosworth, Alysia
Patel, Sunita K.
Sharafeldin, Noha
Chen, Yanjun
Francisco, Liton
Forman, Stephen J.
Wong, F. Lennie
Bhatia, Smita
description Background Cognitive impairment in survivors of blood or bone marrow transplantation (BMT) is well documented. However, to the authors' knowledge, the clinical relevance of self‐endorsed cognitive problems and their relation to objectively assessed cognitive impairment is not known. Methods The authors assessed cognitive impairment in 378 BMT recipients (median age, 52.2 years, 40% of whom were female and 68% of whom were non‐Hispanic white) and 98 healthy controls at 5 predetermined time points: at baseline (before BMT) and at 6 months, 1 year, 2 years, and 3 years after BMT. Self‐endorsed cognitive problems were evaluated using the Neuropsychological Impairment Scale (NIS) and correlated with a standardized 2‐hour battery of objective cognitive testing at each time point. The authors examined the magnitude of difference in self‐endorsed cognitive problems between BMT recipients and healthy controls, and the rate of change in scores over time. Multivariable analyses were used to identify clinical and/or demographic variables associated with self‐endorsed cognitive problems. The authors also examined the association between cognitive impairment and returning to work after BMT. Results Compared with healthy controls, BMT recipients endorsed more cognitive problems (P 
doi_str_mv 10.1002/cncr.32773
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Lennie ; Bhatia, Smita</creator><creatorcontrib>Murdaugh, Donna L. ; Bosworth, Alysia ; Patel, Sunita K. ; Sharafeldin, Noha ; Chen, Yanjun ; Francisco, Liton ; Forman, Stephen J. ; Wong, F. Lennie ; Bhatia, Smita</creatorcontrib><description>Background Cognitive impairment in survivors of blood or bone marrow transplantation (BMT) is well documented. However, to the authors' knowledge, the clinical relevance of self‐endorsed cognitive problems and their relation to objectively assessed cognitive impairment is not known. Methods The authors assessed cognitive impairment in 378 BMT recipients (median age, 52.2 years, 40% of whom were female and 68% of whom were non‐Hispanic white) and 98 healthy controls at 5 predetermined time points: at baseline (before BMT) and at 6 months, 1 year, 2 years, and 3 years after BMT. Self‐endorsed cognitive problems were evaluated using the Neuropsychological Impairment Scale (NIS) and correlated with a standardized 2‐hour battery of objective cognitive testing at each time point. The authors examined the magnitude of difference in self‐endorsed cognitive problems between BMT recipients and healthy controls, and the rate of change in scores over time. Multivariable analyses were used to identify clinical and/or demographic variables associated with self‐endorsed cognitive problems. The authors also examined the association between cognitive impairment and returning to work after BMT. Results Compared with healthy controls, BMT recipients endorsed more cognitive problems (P &lt; .001) at all time points, and the rate of change in NIS scores was found to be significantly greater in BMT recipients. Fatigue was associated with greater endorsement of cognitive problems at 1 year after BMT (odds ratio, 4.23; 95% CI, 2.1‐8.3 [P &lt; .001]). Overall, there was a statistically significant, modest correlation noted between self‐endorsed cognitive problems and objective cognitive impairment (range, 0.401‐0.445 [P ≤ .01]). Higher self‐endorsed cognitive problems were associated with a 3.7‐fold (P = .02) higher odds of not returning to work at 3 years after BMT. Conclusions The results of the current study demonstrated that self‐endorsed cognitive problems can help to identify vulnerable patient subpopulations for detailed cognitive assessment and possible cognitive remediation. The results of the current study indicate that recipients of blood or bone marrow transplantation (BMT) are more likely to endorse cognitive impairment (CI) compared with controls, and that the severity of self‐endorsed CI increases with time. Self‐endorsed and objective testing of cognitive problems are associated with a higher likelihood of not returning to work among recipients of BMT, suggesting that a simple self‐administered assessment could help in screening those individuals at risk of CI.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.32773</identifier><identifier>PMID: 32097508</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Aged ; Blood ; blood or bone marrow transplantation (BMT) ; Blood Transfusion ; Bone marrow ; Bone marrow transplantation ; Bone Marrow Transplantation - adverse effects ; cancer survivors ; Case-Control Studies ; Cognitive ability ; Cognitive Dysfunction - diagnosis ; Cognitive Dysfunction - etiology ; cognitive impairment ; Correlation analysis ; Demographic variables ; Endorsements ; Female ; Humans ; Impairment ; longitudinal ; Longitudinal Studies ; Male ; Middle Aged ; Multivariable control ; Neuropsychological Tests ; Oncology ; return to work ; Self Report ; Statistical analysis ; Stem cell transplantation ; Subpopulations ; Transfusion Reaction - psychology ; Transplantation ; Young Adult</subject><ispartof>Cancer, 2020-05, Vol.126 (10), p.2174-2182</ispartof><rights>2020 American Cancer Society</rights><rights>2020 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4483-2bc83f2bfd5f9987d549780d3674d5cf9afe4400f6dc1e9e01e2cf2b300bfc573</citedby><cites>FETCH-LOGICAL-c4483-2bc83f2bfd5f9987d549780d3674d5cf9afe4400f6dc1e9e01e2cf2b300bfc573</cites><orcidid>0000-0001-8550-8353 ; 0000-0002-9023-8391 ; 0000-0002-0662-5699 ; 0000-0002-7755-5683</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32097508$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Murdaugh, Donna L.</creatorcontrib><creatorcontrib>Bosworth, Alysia</creatorcontrib><creatorcontrib>Patel, Sunita K.</creatorcontrib><creatorcontrib>Sharafeldin, Noha</creatorcontrib><creatorcontrib>Chen, Yanjun</creatorcontrib><creatorcontrib>Francisco, Liton</creatorcontrib><creatorcontrib>Forman, Stephen J.</creatorcontrib><creatorcontrib>Wong, F. Lennie</creatorcontrib><creatorcontrib>Bhatia, Smita</creatorcontrib><title>Self‐endorsed cognitive problems versus objectively assessed cognitive impairment in blood or bone marrow transplantation recipients: A longitudinal study</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Background Cognitive impairment in survivors of blood or bone marrow transplantation (BMT) is well documented. However, to the authors' knowledge, the clinical relevance of self‐endorsed cognitive problems and their relation to objectively assessed cognitive impairment is not known. Methods The authors assessed cognitive impairment in 378 BMT recipients (median age, 52.2 years, 40% of whom were female and 68% of whom were non‐Hispanic white) and 98 healthy controls at 5 predetermined time points: at baseline (before BMT) and at 6 months, 1 year, 2 years, and 3 years after BMT. Self‐endorsed cognitive problems were evaluated using the Neuropsychological Impairment Scale (NIS) and correlated with a standardized 2‐hour battery of objective cognitive testing at each time point. The authors examined the magnitude of difference in self‐endorsed cognitive problems between BMT recipients and healthy controls, and the rate of change in scores over time. Multivariable analyses were used to identify clinical and/or demographic variables associated with self‐endorsed cognitive problems. The authors also examined the association between cognitive impairment and returning to work after BMT. Results Compared with healthy controls, BMT recipients endorsed more cognitive problems (P &lt; .001) at all time points, and the rate of change in NIS scores was found to be significantly greater in BMT recipients. Fatigue was associated with greater endorsement of cognitive problems at 1 year after BMT (odds ratio, 4.23; 95% CI, 2.1‐8.3 [P &lt; .001]). Overall, there was a statistically significant, modest correlation noted between self‐endorsed cognitive problems and objective cognitive impairment (range, 0.401‐0.445 [P ≤ .01]). Higher self‐endorsed cognitive problems were associated with a 3.7‐fold (P = .02) higher odds of not returning to work at 3 years after BMT. Conclusions The results of the current study demonstrated that self‐endorsed cognitive problems can help to identify vulnerable patient subpopulations for detailed cognitive assessment and possible cognitive remediation. The results of the current study indicate that recipients of blood or bone marrow transplantation (BMT) are more likely to endorse cognitive impairment (CI) compared with controls, and that the severity of self‐endorsed CI increases with time. Self‐endorsed and objective testing of cognitive problems are associated with a higher likelihood of not returning to work among recipients of BMT, suggesting that a simple self‐administered assessment could help in screening those individuals at risk of CI.</description><subject>Adult</subject><subject>Aged</subject><subject>Blood</subject><subject>blood or bone marrow transplantation (BMT)</subject><subject>Blood Transfusion</subject><subject>Bone marrow</subject><subject>Bone marrow transplantation</subject><subject>Bone Marrow Transplantation - adverse effects</subject><subject>cancer survivors</subject><subject>Case-Control Studies</subject><subject>Cognitive ability</subject><subject>Cognitive Dysfunction - diagnosis</subject><subject>Cognitive Dysfunction - etiology</subject><subject>cognitive impairment</subject><subject>Correlation analysis</subject><subject>Demographic variables</subject><subject>Endorsements</subject><subject>Female</subject><subject>Humans</subject><subject>Impairment</subject><subject>longitudinal</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariable control</subject><subject>Neuropsychological Tests</subject><subject>Oncology</subject><subject>return to work</subject><subject>Self Report</subject><subject>Statistical analysis</subject><subject>Stem cell transplantation</subject><subject>Subpopulations</subject><subject>Transfusion Reaction - psychology</subject><subject>Transplantation</subject><subject>Young Adult</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kcuKFDEUhoMoTs_oxgeQgBsRakzl0qlyIQyNNxgUvIC7kEpOtWlSSU1S1UPv5hF8AJ_OJzFtj4PjwlUSzpeP__Aj9KgmpzUh9LkJJp0yKiW7gxY1aWVFak7vogUhpKkEZ1-P0HHOm_KUVLD76IjRQgnSLNCPT-D7n1ffIdiYMlhs4jq4yW0Bjyl2HoaMt5DynHHsNmD2E7_DOmfIt3E3jNqlAcKEXcCdj9HimHAXA-BBpxQv8ZR0yKPXYdKTiwEnMG505Ud-gc-wj2Htptm6oD3O5bJ7gO712md4eH2eoC-vX31eva3OP7x5tzo7rwznDatoZxrW0663om_bRlrBW9kQy5aSW2H6VvfAOSH90poaWiA1UFN4RkjXGyHZCXp58I5zN4A1JVHSXo3JleA7FbVTtyfBfVPruFWybThdiiJ4ei1I8WKGPKnBZQO-rApxzoqypaBESF4X9Mk_6CbOqay8p1pBOWmXpFDPDpRJMecE_U2Ymqh96WpfuvpdeoEf_x3_Bv3TcgHqA3DpPOz-o1Kr96uPB-kv0fy-hw</recordid><startdate>20200515</startdate><enddate>20200515</enddate><creator>Murdaugh, Donna L.</creator><creator>Bosworth, Alysia</creator><creator>Patel, Sunita K.</creator><creator>Sharafeldin, Noha</creator><creator>Chen, Yanjun</creator><creator>Francisco, Liton</creator><creator>Forman, Stephen J.</creator><creator>Wong, F. Lennie</creator><creator>Bhatia, Smita</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-8550-8353</orcidid><orcidid>https://orcid.org/0000-0002-9023-8391</orcidid><orcidid>https://orcid.org/0000-0002-0662-5699</orcidid><orcidid>https://orcid.org/0000-0002-7755-5683</orcidid></search><sort><creationdate>20200515</creationdate><title>Self‐endorsed cognitive problems versus objectively assessed cognitive impairment in blood or bone marrow transplantation recipients: A longitudinal study</title><author>Murdaugh, Donna L. ; Bosworth, Alysia ; Patel, Sunita K. ; Sharafeldin, Noha ; Chen, Yanjun ; Francisco, Liton ; Forman, Stephen J. ; Wong, F. Lennie ; Bhatia, Smita</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4483-2bc83f2bfd5f9987d549780d3674d5cf9afe4400f6dc1e9e01e2cf2b300bfc573</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Blood</topic><topic>blood or bone marrow transplantation (BMT)</topic><topic>Blood Transfusion</topic><topic>Bone marrow</topic><topic>Bone marrow transplantation</topic><topic>Bone Marrow Transplantation - adverse effects</topic><topic>cancer survivors</topic><topic>Case-Control Studies</topic><topic>Cognitive ability</topic><topic>Cognitive Dysfunction - diagnosis</topic><topic>Cognitive Dysfunction - etiology</topic><topic>cognitive impairment</topic><topic>Correlation analysis</topic><topic>Demographic variables</topic><topic>Endorsements</topic><topic>Female</topic><topic>Humans</topic><topic>Impairment</topic><topic>longitudinal</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariable control</topic><topic>Neuropsychological Tests</topic><topic>Oncology</topic><topic>return to work</topic><topic>Self Report</topic><topic>Statistical analysis</topic><topic>Stem cell transplantation</topic><topic>Subpopulations</topic><topic>Transfusion Reaction - psychology</topic><topic>Transplantation</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Murdaugh, Donna L.</creatorcontrib><creatorcontrib>Bosworth, Alysia</creatorcontrib><creatorcontrib>Patel, Sunita K.</creatorcontrib><creatorcontrib>Sharafeldin, Noha</creatorcontrib><creatorcontrib>Chen, Yanjun</creatorcontrib><creatorcontrib>Francisco, Liton</creatorcontrib><creatorcontrib>Forman, Stephen J.</creatorcontrib><creatorcontrib>Wong, F. Lennie</creatorcontrib><creatorcontrib>Bhatia, Smita</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Murdaugh, Donna L.</au><au>Bosworth, Alysia</au><au>Patel, Sunita K.</au><au>Sharafeldin, Noha</au><au>Chen, Yanjun</au><au>Francisco, Liton</au><au>Forman, Stephen J.</au><au>Wong, F. Lennie</au><au>Bhatia, Smita</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Self‐endorsed cognitive problems versus objectively assessed cognitive impairment in blood or bone marrow transplantation recipients: A longitudinal study</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2020-05-15</date><risdate>2020</risdate><volume>126</volume><issue>10</issue><spage>2174</spage><epage>2182</epage><pages>2174-2182</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><abstract>Background Cognitive impairment in survivors of blood or bone marrow transplantation (BMT) is well documented. However, to the authors' knowledge, the clinical relevance of self‐endorsed cognitive problems and their relation to objectively assessed cognitive impairment is not known. Methods The authors assessed cognitive impairment in 378 BMT recipients (median age, 52.2 years, 40% of whom were female and 68% of whom were non‐Hispanic white) and 98 healthy controls at 5 predetermined time points: at baseline (before BMT) and at 6 months, 1 year, 2 years, and 3 years after BMT. Self‐endorsed cognitive problems were evaluated using the Neuropsychological Impairment Scale (NIS) and correlated with a standardized 2‐hour battery of objective cognitive testing at each time point. The authors examined the magnitude of difference in self‐endorsed cognitive problems between BMT recipients and healthy controls, and the rate of change in scores over time. Multivariable analyses were used to identify clinical and/or demographic variables associated with self‐endorsed cognitive problems. The authors also examined the association between cognitive impairment and returning to work after BMT. Results Compared with healthy controls, BMT recipients endorsed more cognitive problems (P &lt; .001) at all time points, and the rate of change in NIS scores was found to be significantly greater in BMT recipients. Fatigue was associated with greater endorsement of cognitive problems at 1 year after BMT (odds ratio, 4.23; 95% CI, 2.1‐8.3 [P &lt; .001]). Overall, there was a statistically significant, modest correlation noted between self‐endorsed cognitive problems and objective cognitive impairment (range, 0.401‐0.445 [P ≤ .01]). Higher self‐endorsed cognitive problems were associated with a 3.7‐fold (P = .02) higher odds of not returning to work at 3 years after BMT. Conclusions The results of the current study demonstrated that self‐endorsed cognitive problems can help to identify vulnerable patient subpopulations for detailed cognitive assessment and possible cognitive remediation. The results of the current study indicate that recipients of blood or bone marrow transplantation (BMT) are more likely to endorse cognitive impairment (CI) compared with controls, and that the severity of self‐endorsed CI increases with time. Self‐endorsed and objective testing of cognitive problems are associated with a higher likelihood of not returning to work among recipients of BMT, suggesting that a simple self‐administered assessment could help in screening those individuals at risk of CI.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32097508</pmid><doi>10.1002/cncr.32773</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-8550-8353</orcidid><orcidid>https://orcid.org/0000-0002-9023-8391</orcidid><orcidid>https://orcid.org/0000-0002-0662-5699</orcidid><orcidid>https://orcid.org/0000-0002-7755-5683</orcidid><oa>free_for_read</oa></addata></record>
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source Wiley-Blackwell Read & Publish Collection; EZB Electronic Journals Library
subjects Adult
Aged
Blood
blood or bone marrow transplantation (BMT)
Blood Transfusion
Bone marrow
Bone marrow transplantation
Bone Marrow Transplantation - adverse effects
cancer survivors
Case-Control Studies
Cognitive ability
Cognitive Dysfunction - diagnosis
Cognitive Dysfunction - etiology
cognitive impairment
Correlation analysis
Demographic variables
Endorsements
Female
Humans
Impairment
longitudinal
Longitudinal Studies
Male
Middle Aged
Multivariable control
Neuropsychological Tests
Oncology
return to work
Self Report
Statistical analysis
Stem cell transplantation
Subpopulations
Transfusion Reaction - psychology
Transplantation
Young Adult
title Self‐endorsed cognitive problems versus objectively assessed cognitive impairment in blood or bone marrow transplantation recipients: A longitudinal study
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