Prevalence and influencing factors of cognitive impairment in lung cancer patients undergoing chemotherapy_West China Medical Journal

Authors：

LUO Yu ^1,2 , YANG Xue ^1,2 ,  WANG Li ^2,3

1. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Lung Cancer Center / Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

WANG Li, Email: wangli37029192@sina.com

Keywords：

Lung neoplasms; cognitive impairment; influencing factor; cross-sectional study

DOI：

10.7507/1002-0179.202412096

Video：

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Objective To investigate the prevalence of cognitive impairment and identify its influencing factors among lung cancer patients undergoing chemotherapy, providing a scientific basis for targeted interventions. Methods A convenience sample of lung cancer patients receiving chemotherapy at West China Hospital, Sichuan University between April and October 2024 was enrolled. Data were collected using a general information questionnaire, the Mini-Mental State Examination, Nutritional Risk Screening 2002, Hospital Anxiety and Depression Scale, Barthel index, and FRAIL scale. Univariate analyses and multivariate logistic regression were performed to determine factors associated with cognitive impairment. Results A total of 380 patients undergoing chemotherapy for lung cancer were enrolled, and 205 (53.9%) of them had cognitive impairment. Univariate analyses revealed that there were statistically significant differences between the cognitively normal group and the cognitive impairment group in age, educational level, work status, nutritional status, Barthel index, and FRAIL scale score (P<0.05). Multivariate logistic regression showed that advanced age [odds ratio (OR)=1.045, 95% confidence interval (CI) (1.015, 1.075), P=0.002] and FRAIL scale score [OR=1.369, 95%CI (1.165, 1.609), P<0.001] were identified as independent risk factors for cognitive impairment, whereas higher educational attainment served as a protective factor, compared with patients with primary school education or below, patients with junior high school, high school/secondary vocational school, college, or undergraduate education and above had a lower risk of cognitive impairment [OR=0.437, 0.258, 0.243, 0.120, P<0.05]. Conclusions Cognitive impairment is highly prevalent among lung cancer patients undergoing chemotherapy and is significantly influenced by age, educational level, and frailty. Healthcare providers should develop targeted interventions based on these factors to reduce the prevalence of cognitive impairment.

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12.	原陈珊, 来云霞. 3 种营养筛查工具在骨与软组织肿瘤患者营养不良风险评估中的临床价值. 中国食物与营养, 2024, 30(7): 82-85, 89.
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14.	李田园, 潘琦, 张梅, 等. 应用医院用焦虑抑郁量表探讨住院 2 型糖尿病患者焦虑抑郁的发生风险. 中国糖尿病杂志, 2019, 27(9): 671-676.
15.	黄春丽, 张海英, 张琰, 等. “互联网+延续性护理”对轻度失能老年患者生活质量及家庭照顾者准备度的影响. 中国老年保健医学, 2024, 22(3): 160-164.
16.	李晨, 江珊, 汪欣, 等. 三种衰弱评估工具对老年慢性心力衰竭患者不良结局预测能力的比较. 中华老年心脑血管病杂志, 2024, 26(10): 1125-1129.
17.	高鹏, 王亮, 王宏宇, 等. 衰弱量表评分及衰弱指数与老年患者髋关节置换术后康复效果的相关性分析. 中国康复医学杂志, 2024, 39(4): 529-534.
18.	李明妍, 王睿哲, 易莹莹, 等. 癌症病人衰弱评估工具的研究进展. 护理研究, 2024, 38(15): 2723-2727.
19.	郭飞, 高昌俊, 袁方明, 等. 老年肺癌患者术后远期认知功能及其影响因素调查分析. 现代肿瘤医学, 2023, 31(7): 1256-1261.
20.	王盼娇, 韩月, 郜文豪. 肺癌患者化疗期间睡眠质量状况及对策方案的制定与实施效果分析. 黑龙江医药, 2024, 37(5): 1232-1234.
21.	李芙兰, 谢海霞, 于天爽, 等. 肺癌患者化疗期间症状群的范围综述. 中华护理杂志, 2024, 59(18): 2283-2289.
22.	王欢, 张磊. 同步放化疗对非小细胞肺癌患者近期疗效、肺功能的影响. 现代医学与健康研究电子杂志, 2024, 8(16): 64-66.
23.	苏崇玉, 王宇轩, 史抗, 等. 老年肺癌患者全身麻醉胸腔镜手术术后发生认知功能障碍的影响因素分析. 中国医刊, 2024, 59(6): 627-630.
24.	Hou T, Peng W, Ho MH, et al. Factors associated with cancer-related cognitive impairment in patients with lung cancer: a systematic review. Eur J Oncol Nurs, 2024, 71: 102657.
25.	欧阳筱瑶, 李战胜, 孙舒悦, 等. 健康生态学视角下社区老年 2 型糖尿病患者轻度认知障碍现状及影响因素分析. 华南预防医学, 2023, 49(7): 828-833.
26.	陈玲, 杨连招, 陆静钰, 等. 南宁市社区老年高血压患者轻度认知障碍现状及影响因素研究. 中华护理教育, 2022, 19(6): 566-571.
27.	徐盼, 王乐, 张园, 等. 老年性聋患者的认知功能影响因素探究. 中华耳科学杂志, 2023, 21(1): 69-75.
28.	罗琴, 石强, 龚清平, 等. 不同类型睡眠障碍对帕金森病患者认知功能的影响分析. 中国临床神经科学, 2022, 30(5): 575-580.
29.	董凯生, 陶香君, 王颖, 等. 首发脑梗死患者急性期血管性认知功能障碍的影响因素分析. 中国病案, 2024, 25(6): 103-106.
30.	连周燕, 杜影. 上海市社区老年人牙列状态及其与衰弱和认知功能的关系. 中国初级卫生保健, 2024, 38(9): 35-38.
31.	赵璨, 刘姗姗, 李净兵, 等. 老年高血压伴衰弱患者认知功能障碍的危险因素及与不良预后的关系. 心血管康复医学杂志, 2024, 33(4): 391-394.

1. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin, 2024, 74(1): 12-49.
2. Oliver AL. Lung cancer: epidemiology and screening. Surg Clin North Am, 2022, 102(3): 335-344.
3. Barta JA, Powell CA, Wisnivesky JP. Global epidemiology of lung cancer. Ann Glob Health, 2019, 85(1): 8.
4. Howington JA, Blum MG, Chang AC, et al. Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.
5. Lange M, Joly F, Vardy J, et al. Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors. Ann Oncol, 2019, 30(12): 1925-1940.
6. Binarelli G, Duivon M, Joly F, et al. Cancer-related cognitive impairment: current perspectives on the management of cognitive changes following cancer treatment. Expert Rev Neurother, 2023, 23(3): 249-268.
7. Eggen AC, Richard NM, Bosma I, et al. Factors associated with cognitive impairment and cognitive concerns in patients with metastatic non-small cell lung cancer. Neurooncol Pract, 2021, 9(1): 50-58.
8. Simó M, Root JC, Vaquero L, et al. Cognitive and brain structural changes in a lung cancer population. J Thorac Oncol, 2015, 10(1): 38-45.
9. Fleming B, Edison P, Kenny L. Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management. BMJ, 2023, 380: e071726.
10. 贺佳, 尹平. 医学统计学. 2 版. 北京: 高等教育出版社, 2020: 296-297.
11. 丁华, 王堃, 赵忻怡, 等. 老年人认知功能状况的相关因素. 中国心理卫生杂志, 2022, 36(3): 197-203.
12. 原陈珊, 来云霞. 3 种营养筛查工具在骨与软组织肿瘤患者营养不良风险评估中的临床价值. 中国食物与营养, 2024, 30(7): 82-85, 89.
13. 马莹, 刘艳军, 李春燕, 等. 医院焦虑抑郁量表用于耳鼻咽喉科住院患者心理状态评估的调查研究. 肿瘤预防与治疗, 2020, 33(6): 519-524.
14. 李田园, 潘琦, 张梅, 等. 应用医院用焦虑抑郁量表探讨住院 2 型糖尿病患者焦虑抑郁的发生风险. 中国糖尿病杂志, 2019, 27(9): 671-676.
15. 黄春丽, 张海英, 张琰, 等. “互联网+延续性护理”对轻度失能老年患者生活质量及家庭照顾者准备度的影响. 中国老年保健医学, 2024, 22(3): 160-164.
16. 李晨, 江珊, 汪欣, 等. 三种衰弱评估工具对老年慢性心力衰竭患者不良结局预测能力的比较. 中华老年心脑血管病杂志, 2024, 26(10): 1125-1129.
17. 高鹏, 王亮, 王宏宇, 等. 衰弱量表评分及衰弱指数与老年患者髋关节置换术后康复效果的相关性分析. 中国康复医学杂志, 2024, 39(4): 529-534.
18. 李明妍, 王睿哲, 易莹莹, 等. 癌症病人衰弱评估工具的研究进展. 护理研究, 2024, 38(15): 2723-2727.
19. 郭飞, 高昌俊, 袁方明, 等. 老年肺癌患者术后远期认知功能及其影响因素调查分析. 现代肿瘤医学, 2023, 31(7): 1256-1261.
20. 王盼娇, 韩月, 郜文豪. 肺癌患者化疗期间睡眠质量状况及对策方案的制定与实施效果分析. 黑龙江医药, 2024, 37(5): 1232-1234.
21. 李芙兰, 谢海霞, 于天爽, 等. 肺癌患者化疗期间症状群的范围综述. 中华护理杂志, 2024, 59(18): 2283-2289.
22. 王欢, 张磊. 同步放化疗对非小细胞肺癌患者近期疗效、肺功能的影响. 现代医学与健康研究电子杂志, 2024, 8(16): 64-66.
23. 苏崇玉, 王宇轩, 史抗, 等. 老年肺癌患者全身麻醉胸腔镜手术术后发生认知功能障碍的影响因素分析. 中国医刊, 2024, 59(6): 627-630.
24. Hou T, Peng W, Ho MH, et al. Factors associated with cancer-related cognitive impairment in patients with lung cancer: a systematic review. Eur J Oncol Nurs, 2024, 71: 102657.
25. 欧阳筱瑶, 李战胜, 孙舒悦, 等. 健康生态学视角下社区老年 2 型糖尿病患者轻度认知障碍现状及影响因素分析. 华南预防医学, 2023, 49(7): 828-833.
26. 陈玲, 杨连招, 陆静钰, 等. 南宁市社区老年高血压患者轻度认知障碍现状及影响因素研究. 中华护理教育, 2022, 19(6): 566-571.
27. 徐盼, 王乐, 张园, 等. 老年性聋患者的认知功能影响因素探究. 中华耳科学杂志, 2023, 21(1): 69-75.
28. 罗琴, 石强, 龚清平, 等. 不同类型睡眠障碍对帕金森病患者认知功能的影响分析. 中国临床神经科学, 2022, 30(5): 575-580.
29. 董凯生, 陶香君, 王颖, 等. 首发脑梗死患者急性期血管性认知功能障碍的影响因素分析. 中国病案, 2024, 25(6): 103-106.
30. 连周燕, 杜影. 上海市社区老年人牙列状态及其与衰弱和认知功能的关系. 中国初级卫生保健, 2024, 38(9): 35-38.
31. 赵璨, 刘姗姗, 李净兵, 等. 老年高血压伴衰弱患者认知功能障碍的危险因素及与不良预后的关系. 心血管康复医学杂志, 2024, 33(4): 391-394.

West China Medical Journal

Latest ArticlesPrevalence and influencing factors of cognitive impairment in lung cancer patients undergoing chemotherapy

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