Purpose To explore the heterogeneous trajectories of subjective cognitive function in breast cancer patients undergoing chemotherapy, and to identify the demographic features and psycho-behavioral trends in different classes. Methods A longitudinal study was conducted from September 2021 to May 2023 among a total of 282 breast cancer patients receiving chemotherapy. Data were collected at: before the first chemotherapy (T0), 1 month (T1), 3 months (T2), 6 months (T3), and 9 months (T4) after the first chemotherapy. Latent class growth model (LCGM) was applied to identify heterogeneous trajectories of subjective cognitive function. Multiple logistic regression was used to explore the related factors of different classes. Generalized estimated equation (GEE) was employed to explore the trends of psycho-behavioral modes among participants. Results Four heterogeneous trajectories were identified: the “no impairment class” (n = 158, 55.8%), the “impair-recover class” (n = 64, 22.9%), the “delayed recovery class” (n = 48, 17.2%), and the “persistent impaired class” (n = 12, 4.1%). These four classes exhibited a distinct trend of subjective cognitive function from T0 to T4. Compared to the “no impairment class,” the “impair-recover class” had older age (OR = 1.278, padj = 0.015), postmenopausal (OR = 0.085, padjusted = 0.006), higher anxiety (OR = 2.157, padjusted < 0.001), and depression (OR = 3.057, padjusted < 0.001); the “delayed recovery class” showed older age (OR = 2.060, padjusted < 0.001), postmenopausal (OR = 0.009, padjusted < 0.001), > 4 weeks of chemotherapy (OR = 0.202, padjusted = 0.036), receiving ACP regimen (OR = 3.182, padjusted < 0.009), higher anxiety (OR = 3.200, padjusted < 0.001), depression (OR = 4.837, padjusted < 0.001), and cancer-related fatigue (OR = 1.173, padjusted = 0.033); and the “persistent impaired class” exhibited older age (OR = 3.060, padjusted < 0.001), higher depression (OR = 3.293, padjusted = 0.003), greater fatigue (OR = 1.301, padjusted = 0.009), and lower daily activities (OR = 0.993, padjusted = 0.021). The psycho-behavioral pattern differed among these classes. Conclusion This study provides insights into the heterogeneous trajectories of subjective cognitive function in breast cancer patients undergoing chemotherapy and highlights the importance of considering demographic and psycho-behavioral factors in identifying and managing chemotherapy-related cognitive impairment.

Trajectories and related factors of subjective cognitive function in patients living with breast cancer receiving postoperative chemotherapy: a latent class growth model study

期刊论文
发表日期：

2025年10月31日

查看全文

Yu Bi,
Yuanfeng Lu,
Xiujuan Gao,
Xiuju Shi,
Aihua Zhang

摘要

Purpose

To explore the heterogeneous trajectories of subjective cognitive function in breast cancer patients undergoing chemotherapy, and to identify the demographic features and psycho-behavioral trends in different classes.

Methods

A longitudinal study was conducted from September 2021 to May 2023 among a total of 282 breast cancer patients receiving chemotherapy. Data were collected at: before the first chemotherapy (T0), 1 month (T1), 3 months (T2), 6 months (T3), and 9 months (T4) after the first chemotherapy. Latent class growth model (LCGM) was applied to identify heterogeneous trajectories of subjective cognitive function. Multiple logistic regression was used to explore the related factors of different classes. Generalized estimated equation (GEE) was employed to explore the trends of psycho-behavioral modes among participants.

Results

Four heterogeneous trajectories were identified: the “no impairment class” (n = 158, 55.8%), the “impair-recover class” (n = 64, 22.9%), the “delayed recovery class” (n = 48, 17.2%), and the “persistent impaired class” (n = 12, 4.1%). These four classes exhibited a distinct trend of subjective cognitive function from T0 to T4. Compared to the “no impairment class,” the “impair-recover class” had older age (OR = 1.278, p_adj = 0.015), postmenopausal (OR = 0.085, p_adjusted = 0.006), higher anxiety (OR = 2.157, p_adjusted < 0.001), and depression (OR = 3.057, p_adjusted < 0.001); the “delayed recovery class” showed older age (OR = 2.060, p_adjusted < 0.001), postmenopausal (OR = 0.009, p_adjusted < 0.001), > 4 weeks of chemotherapy (OR = 0.202, p_adjusted = 0.036), receiving ACP regimen (OR = 3.182, p_adjusted < 0.009), higher anxiety (OR = 3.200, p_adjusted < 0.001), depression (OR = 4.837, p_adjusted < 0.001), and cancer-related fatigue (OR = 1.173, p_adjusted = 0.033); and the “persistent impaired class” exhibited older age (OR = 3.060, p_adjusted < 0.001), higher depression (OR = 3.293, p_adjusted = 0.003), greater fatigue (OR = 1.301, p_adjusted = 0.009), and lower daily activities (OR = 0.993, p_adjusted = 0.021). The psycho-behavioral pattern differed among these classes.

Conclusion

This study provides insights into the heterogeneous trajectories of subjective cognitive function in breast cancer patients undergoing chemotherapy and highlights the importance of considering demographic and psycho-behavioral factors in identifying and managing chemotherapy-related cognitive impairment.