Physical activity and cognition: Longitudinal findings from the Thinking and Living with Cancer Study Journal Article


Authors: Artese, A. L.; Zhou, X.; Tometich, D. B.; Small, B. J.; Ahles, T. A.; Ahn, J.; Bethea, T. N.; Breen, E. C.; Cohen, H. J.; Extermann, M.; Graham, D.; Isaacs, C.; Jim, H. S. L.; McDonald, B. C.; Nakamura, Z. M.; Patel, S. K.; Rentscher, K. E.; Root, J. C.; Saykin, A. J.; Van Dyk, K.; Zhai, W.; Carroll, J. E.; Mandelblatt, J.
Article Title: Physical activity and cognition: Longitudinal findings from the Thinking and Living with Cancer Study
Abstract: BACKGROUND: Physical activity can improve cognition; however, little is known regarding the relationships between longitudinal objectively measured physical activity, cognition, and inflammation in older breast cancer survivors. METHODS: Older (aged 60 years and older) breast cancer survivors (n = 216) and frequency-matched noncancer control participants (n = 216) were assessed at baseline (presystemic therapy for survivors) and annually for up to 5 years. Assessments included hip-worn actigraphs worn for 7 days, neuropsychological tests, the Functional Assessment of Cancer Therapy-Cognitive Function perceived cognitive impairment subscale, and circulating levels of C-reactive protein and interleukin-6. Data were analyzed using linear mixed-effect, random-effect contemporaneous fluctuation, and multilevel mediation models, considering covariates; a P value less than .05 (2-sided) was considered statistically significant. RESULTS: Survivors had fewer minutes of moderate-to-vigorous physical activity than controls at 36-, 48-, and 60-month time points (P < .03). Fewer survivors met aerobic physical activity guidelines at 36 months than control participants (17.7% vs 33.0%, P = .030). When guidelines were met (vs not), Functional Assessment of Cancer Therapy-Cognitive Function perceived cognitive impairment scores were 2.1 (1.0) (P = .034) points higher. Higher moderate-to-vigorous physical activity and meeting aerobic guidelines were not related to objective neuropsychological performance. Moderate-to-vigorous physical activity was inversely associated with C-reactive protein and interleukin-6 (P < .001), but inflammation did not mediate physical activity effects on perceived cognition. CONCLUSIONS: Older breast cancer survivors were less physically active than older noncancer controls, especially farther from baseline. Meeting aerobic guidelines was associated with better perceived cognition in survivors. Survivorship care should consider physical activity monitoring and referral to rehabilitation and supervised exercise programs to promote physical activity and improve recovery in older survivors. © The Author(s) 2024. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.
Keywords: aged; middle aged; case control study; case-control studies; c reactive protein; metabolism; inflammation; exercise; psychology; c-reactive protein; breast neoplasms; cancer survivor; blood; longitudinal studies; breast tumor; neuropsychological tests; interleukin 6; interleukin-6; cognition; cognitive defect; neuropsychological assessment; therapy; longitudinal study; etiology; cancer survivors; cognitive dysfunction; humans; human; female
Journal Title: JNCI: Journal of the National Cancer Institute
Volume: 116
Issue: 12
ISSN: 0027-8874
Publisher: Oxford University Press  
Date Published: 2024-12-01
Start Page: 2009
End Page: 2021
Language: English
DOI: 10.1093/jnci/djae182
PUBMED: 39107910
PROVIDER: scopus
PMCID: PMC11630529
DOI/URL:
Notes: Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PDF -- Source: Scopus
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  1. Tim A Ahles
    182 Ahles
  2. James Charles Root
    113 Root