The impact of using different reference populations on measurement of breast cancer-related cognitive impairment rates Journal Article
| Authors: | Clapp, J. D.; Luta, G.; Small, B. J.; Ahles, T. A.; Root, J. C.; Graham, D.; Hurria, A.; Jacobsen, P. B.; Jim, H.; McDonald, B. C.; Stern, R. A.; Saykin, A. J.; Mandelblatt, J. S.; for the Thinking and Living with Cancer (TLC) Study |
| Article Title: | The impact of using different reference populations on measurement of breast cancer-related cognitive impairment rates |
| Abstract: | Objective: To evaluate how use of different reference populations affects estimates of breast cancer-related cognitive impairment rates. Methods: Patients aged ≥60 years with stage 0-3 breast cancer (n = 371) and matched non-cancer controls (n = 370) completed 13 neuropsychological tests prior to systemic therapy or at enrollment (controls). The tests captured three domains: attention, processing speed and executive function; learning and memory; and visual-spatial function. Domain-specific impairment was defined as having one test score 2 SD below or two or more test scores 1.5 SD below the reference population means. Different reference populations were used to define impairment: published normative data, study-specific controls, age and education-stratified controls, and age and education-adjusted controls. The associations between the resultant impairment rates and breast cancer (vs. control) were evaluated using chi-square tests and logistic regression models. Cohen's kappa coefficients were used to evaluate agreement of impairment rates between study-specific control performance and the other reference population groups. Results: The patients and controls were aged 68.0 (SD 6.0) and 67.9 (SD 7.0) years, respectively. The association of breast cancer-control status with impairment did not differ based on reference group. Cognitive impairment based on published normative data yielded less agreement on impairment rates (κ = 0.22-0.89) than study-specific age and education-stratified control performance (κ = 0.62-1.00). Conclusion: The choice of reference populations did not affect conclusions about the association of cognition with breast cancer. However, while study-specific reference populations provided greater internal consistency in defining cognitive impairment, benchmarking against published normative data will enhance the ability to compare results across studies. |
| Journal Title: | Archives of Clinical Neuropsychology |
| Volume: | 33 |
| Issue: | 8 |
| ISSN: | 0887-6177 |
| Publisher: | Oxford University Press |
| Date Published: | 2018-12-01 |
| Start Page: | 956 |
| End Page: | 963 |
| Language: | English |
| DOI: | 10.1093/arclin/acx142 |
| PUBMED: | 29471454 |
| PROVIDER: | scopus |
| PMCID: | PMC6246339 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 December 2018 -- Source: Scopus |
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