Psychological Correlates of Perceived Cognition in Prostate Cancer Patients Two Years Post-Initiation of Androgen Deprivation Therapy

• Published in: Psycho-oncology (Chichester, England) Vol. 23; p. 37
• Main Authors: Cases, Mallory G, Donovan, KristineA, Cessna, Julie M, Hicks, Charissa A, Jim, Heather SL, Jacobsen, Paul B
• Format: Journal Article
• Language: English
• Published: Chichester Wiley Subscription Services, Inc 01.02.2014
• Subjects: Cognitive psychology; Correlation analysis; Endocrine therapy; Mens health; Prostate cancer; Quality of life; Side effects
• ISSN: 1057-9249; 1099-1611

Despite its long clinical success in men with prostate cancer (PC), androgen deprivation therapy (ADT) has a number of distressing side effects. Many men receiving ADT, which blocks testosterone production, report cognitive issues and experience decreases in quality of life (QOL). To date, however, there has been little research on the long-term effects of ADT on QOL and perceived cognition. It was hypothesized that depression, insomnia, and fatigue would be negatively associated with perceived cognition. The sample comprised 28 men receiving ADT for PC who completed measures of perceived cognition (E-COG), depression (CES-D), sleep quality (ISI) and fatigue (FSI) 24 months following initiation of ADT. Univariate analyses were conducted to identify QOL variables significantly correlated with perceived cognition. A linear regression was conducted with perceived cognition as the outcome and depression, fatigue severity, and insomnia as predictors. Two years post-ADT initiation, these men were found to have a mean global perceived cognition score of 1.302 (SD = .429). Depression, insomnia and fatigue were significantly related to perceived cognition in the predicted direction. In multivariate analyses, depression and fatigue emerged as significant predictors (p<.01), but insomnia did not (p = .16). Depression, fatigue, and insomnia accounted for 77% of the variance in perceived cognition (p<.0001). These findings support the hypothesis that higher levels of depression, fatigue and insomnia are associated with poorer perceived cognition. It was found that depression and fatigue predicted perceived cognition. Future research should determine if interventions to improve depression and fatigue lead to improvements in perceived cognition. Future research should determine if interventions to improve depression and fatigue lead to improvements in perceived cognition. Clinicians need to be aware of the association of depression and fatigue with the perception of poorer cognitive functioning. If patients are complaining of poorer cognitive functioning, depression and fatigue may be addressed first if relevant. This research is supported by the NCI grant R01CA132803.