If you’re a breast cancer survivor, your memory might not be as sharp as it used to be. Cognitive problems (not just memory loss, but depleted concentration and problem solving) often occur even after the treatment and cancer has ended. Researchers at UCLA have been conducting a long-term study to find out why that happens.
One possible explanation for the brain fade is long-term inflammation that occurs along with cancer survival. To learn more about the link between inflammation and cognitive problems in breast cancer survivors, a team of researchers from UCLA followed 400 breast cancer survivors for up to five years to see if higher levels of inflammation were associated with these cognitive problems. This type of long-term study is called a longitudinal study, and the researchers named it Thinking and Living with Cancer (TLC) Study.
Four hundred women age 60 or older participated. The average age was between 67 and 68. All the women were diagnosed with stage 0 to stage 3 breast cancer. These women were compared to a control group of 329 women enrolled and matched for age without breast cancer. Women with a prior diagnosis of cancer, neurologic disease or dementia were excluded from the study. Results of the TLC study are published in the Journal of Clinical Oncology.
To measure their cognitive problems, the women were given a common questionnaire that featured questions about cognitive abilities such as memory and task completion. The test was called the Functional Assessment of Cancer Therapy-Cognitive Function scale.
How to Measure Inflammation
To measure inflammation, the women had blood tests for C-reactive protein (CRP). CRP is a protein your liver releases during times of inflammation, such as when your immune system is fighting an infection, injury or cancer. CRP is also used to diagnose inflammation caused by heart disease. Normally CRP should be low, less than 2 milligrams per liter (mg/L). For example, a higher risk for heart attack starts at 2 mg/L.
All the women had their CRP measured at the start of the study which was conducted from 2010 through 2020. Women diagnosed with breast cancer had the blood test before they started treatment. Blood tests and cognitive questionnaires were repeated up to six times over five years. These were the key findings…
- Compared to women in the control group, women with breast cancer had higher CRP levels at the beginning of the study and at 12, 24 and 60 months.
- Higher CRP results predicted lower cognition marks on the cognition questionnaire in the breast cancer group.
- Breast cancer survivors scored 9.5 points lower in the cognition assessment than the control group when their CRP levels were 3 mg/L and 14.2 points lower when their CRP levels were 10 mg/L.
- CRP levels were not associated with cognition in the control group.
- The strongest evidence of cognitive loss was less ability to complete tasks, concentrate and remember things during everyday activities.
Curbing Inflammation and Cognitive Decline
The research team concludes that their study supports the role of chronic inflammation in the development of cognitive problems for older women surviving breast cancer. They suggest CRP testing as one way to find or predict cognitive problems at an early stage. Early interventions may then be effective for reducing inflammation and cognitive decline. These interventions might include physical activity, better sleep, and anti-inflammatory medications.