Cognitive Problems in Older Breast Cancer Survivors May Be Due to Inflammation

Cognitive problems are common among breast cancer patients and survivors, with “chemo brain” one of the most glaring examples. This may manifest itself through memory issues, trouble concentrating, confusion, brain fog, or a shortened attention span. A new study may have found clues as to why this occurs in older patients.

Researchers at UCLA recently investigated possible causes of cognitive issues in older breast cancer survivors, finding that inflammation is a strong candidate. According to findings published in the Journal of Clinical Oncology, it may have something to do with the inflammatory marker known as C-reactive protein, or CRP.

In a study involving 400 survivors and 329 controls, ranging in age from 60 to 90, the team found that higher levels of CRP were linked to participants reporting cognitive problems. Survivors were also found to have higher CRP levels than those without cancer through the five-year mark. Those involved in the study had mostly been treated for stage I estrogen receptor–positive cancer.

The team says they chose to focus on older survivors because they make up the majority of survivors in the United States. Past studies looking for explanations behind cognitive issues have tended to focus on younger survivors and those who have just completed therapy, they explain. This may make it harder to understand longer-term cognitive issues in the older cohort. This study appears to have helped provide more clues.

Elizabeth Breen, co-senior author and professor emerita of psychiatry and biobehavioral sciences at the Cousins Center for Psychoneuroimmunology at UCLA, explains, “Being able to test for levels of inflammation at the same time that cognition was being rigorously evaluated gave the TLC team a potential window into the biology underlying cognitive concerns.”

Cognitive issues were also among the major concerns of participants.

Dr. Jeanne Mandelblatt, co-senior author and professor of oncology at Georgetown University, says, “Cognitive issues affect women’s daily lives years after completing treatment, and their reports of their own ability to complete tasks and remember things was the strongest indicator of problems in this study.”

With the study finding a link between inflammation and cognitive issues, the team says CRP testing could be useful in survivors.