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Consistent Physical Activity and Future Neurocognitive Problems in Adult Survivors of Childhood Cancers: A Report From the Childhood Cancer Survivor Study.

Publication ,  Journal Article
Barlow-Krelina, E; Chen, Y; Yasui, Y; Till, C; Gibson, TM; Ness, KK; Leisenring, WM; Howell, RM; Nathan, PC; Oeffinger, KC; Robison, LL ...
Published in: J Clin Oncol
June 20, 2020

PURPOSE: To investigate longitudinal associations between physical activity (PA) and neurocognitive problems in adult survivors of childhood cancer. METHODS: A total of 12,123 5-year survivors diagnosed between 1970 and 1999 (median [range] age at diagnosis, 7 [0-21] years, time since diagnosis at baseline, 16 [6-30] years) and 720 siblings self-reported PA and neurocognitive problems. PA was collected at baseline, and PA and neurocognitive data were obtained 7 (1-12) years and 12 (9-14) years later. PA consistency was defined as any combination of ≥ 75 minutes of vigorous or 150 minutes of moderate activity per week on all surveys. Multiple linear regressions, conducted separately for CNS and non-CNS survivors, identified associations between PA consistency and neurocognitive outcomes (expected mean, 50; standard deviation [SD], 10). Mediating effects of body mass index (BMI) and chronic health conditions (CHCs) were evaluated. RESULTS: Survivors were less likely than siblings to report consistent PA (28.1% v 33.6%) and more likely to report problems in Task Efficiency (T-scores mean ± SD: siblings, 50.0 ± 0.4; CNS, 61.4 ± 0.4; non-CNS, 53.3 ± 0.3), Emotion Regulation (siblings, 51.4 ± 0.4; CNS, 54.5 ± 0.3; non-CNS 53.4 ± 0.2), and Memory (siblings, 50.8 ± 0.4; CNS, 58.9 ± 0.4; non-CNS, 53.5 ± 0.2; all P < .001). Survivors of CNS cancers (52.8 ± 0.3) also reported poorer Organization than siblings (49.9 ± 0.4; P < .001). After adjusting for age at diagnosis, age at questionnaire, emotional distress, and cancer treatment exposures, consistent PA was associated with fewer neurocognitive problems compared with consistent inactivity for both CNS and non-CNS groups (T-score differences ranging from -7.9 to -2.2) and larger neurocognitive improvements over time (-6.0 to -2.5), all P ≤ .01. BMI and severe CHCs partially mediated the PA-neurocognitive associations, but the mediation effects were small (change in β ≤ 0.4). CONCLUSION: Adult survivors of childhood cancer who report more consistent PA have fewer neurocognitive problems and larger improvements in these concerns many years after treatment.

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Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

June 20, 2020

Volume

38

Issue

18

Start / End Page

2041 / 2052

Location

United States

Related Subject Headings

  • Self Report
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Male
  • Humans
  • Female
  • Exercise
  • Cognition Disorders
  • Cancer Survivors
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
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Barlow-Krelina, E., Chen, Y., Yasui, Y., Till, C., Gibson, T. M., Ness, K. K., … Edelstein, K. (2020). Consistent Physical Activity and Future Neurocognitive Problems in Adult Survivors of Childhood Cancers: A Report From the Childhood Cancer Survivor Study. J Clin Oncol, 38(18), 2041–2052. https://doi.org/10.1200/JCO.19.02677
Barlow-Krelina, Emily, Yan Chen, Yutaka Yasui, Christine Till, Todd M. Gibson, Kirsten K. Ness, Wendy M. Leisenring, et al. “Consistent Physical Activity and Future Neurocognitive Problems in Adult Survivors of Childhood Cancers: A Report From the Childhood Cancer Survivor Study.J Clin Oncol 38, no. 18 (June 20, 2020): 2041–52. https://doi.org/10.1200/JCO.19.02677.
Barlow-Krelina E, Chen Y, Yasui Y, Till C, Gibson TM, Ness KK, et al. Consistent Physical Activity and Future Neurocognitive Problems in Adult Survivors of Childhood Cancers: A Report From the Childhood Cancer Survivor Study. J Clin Oncol. 2020 Jun 20;38(18):2041–52.
Barlow-Krelina, Emily, et al. “Consistent Physical Activity and Future Neurocognitive Problems in Adult Survivors of Childhood Cancers: A Report From the Childhood Cancer Survivor Study.J Clin Oncol, vol. 38, no. 18, June 2020, pp. 2041–52. Pubmed, doi:10.1200/JCO.19.02677.
Barlow-Krelina E, Chen Y, Yasui Y, Till C, Gibson TM, Ness KK, Leisenring WM, Howell RM, Nathan PC, Oeffinger KC, Robison LL, Armstrong GT, Krull KR, Edelstein K. Consistent Physical Activity and Future Neurocognitive Problems in Adult Survivors of Childhood Cancers: A Report From the Childhood Cancer Survivor Study. J Clin Oncol. 2020 Jun 20;38(18):2041–2052.

Published In

J Clin Oncol

DOI

EISSN

1527-7755

Publication Date

June 20, 2020

Volume

38

Issue

18

Start / End Page

2041 / 2052

Location

United States

Related Subject Headings

  • Self Report
  • Retrospective Studies
  • Oncology & Carcinogenesis
  • Male
  • Humans
  • Female
  • Exercise
  • Cognition Disorders
  • Cancer Survivors
  • Adult