Neurocognitive Impairment Up in Childhood Cancer Survivors

Fatigue and sleep disorders increase risk of neurocognitive impairment

MONDAY, April 11 (HealthDay News) -- Survivors of childhood cancer may be at risk of neurocognitive impairment associated with fatigue and sleep disorders, according to a study published online April 11 in Cancer.

Nancy R. Clanton, Ph.D., from St. Jude Children's Research Hospital in Memphis, Tenn., and colleagues assessed the correlation between fatigue, sleep problems, and neurocognitive impairment in 1,426 survivors from the Childhood Cancer Survivor Study. The investigators used demographic and treatment factors, survivor reports on the Functional Assessment of Chronic Illness Therapy-Fatigue, the Short Form-36 Vitality Scale, the Pittsburgh Sleep Quality Index, and the Epworth Sleepiness Scale to evaluate relative risks for neurocognitive impairment.

The researchers found that more than 20 percent of survivors had neurocognitive impairment, when compared with sibling controls. Fatigue (risk ratio [RR], 1.34), daytime sleepiness (RR, 1.68), poor sleep quality (RR, 1.23), and decreased vitality (RR, 1.75) were correlated with impaired task ability. Fatigue (RR, 1.77), sleepiness (RR, 1.38), and reduced vitality (RR, 3.08) predicted difficulties in emotional regulation. Sleepiness (RR, 1.80) and decreased vitality (1.90) were associated with decreased organization; whereas, poor sleep quality (RR, 1.45), increased sleepiness (RR, 2.05), and decreased vitality (RR, 2.01) were associated with impaired memory. Outcomes were not affected by cranial radiation therapy, steroids and antimetabolite chemotherapy, gender, or current age.

"Neurocognitive function in long-term survivors of childhood cancer appears particularly vulnerable to the effects of fatigue and sleep disruption. These findings suggest sleep hygiene should be emphasized among survivors, as it may provide an additional mechanism for intervention to improve neurocognitive outcomes," the authors write.

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