PILOT STUDY ON BREAST CANCER, CHEMOTHERAPY, AGE AND UFOV

这份R03申请针对的是NIA(PAR-02-049)的目标“老年癌症”(#7)，并与“行为医学基础研究”(#8)、“背景认知”(#12)和“改进的措施和方法”(#24)相关。绝经后女性的乳腺癌发病率急剧上升，并随着年龄的增长而增加。暴露调整后的撞车风险随着年龄的增长而上升，与驾驶等重要日常活动高度相关的认知指标的得分也往往会随着年龄的增长而下降。化疗是乳腺癌的标准治疗方法，与神经心理测试中表现较差有关。然而，化疗对与日常功能(如驾驶)关系最密切的认知测试成绩的影响尚未得到研究，也没有研究年龄和化疗对认知功能的交互作用。我们将进行一项创新的试点研究，以探索乳腺癌化疗是否与认知测试的表现受损有关，认知测试与包括驾驶在内的重要活动的表现高度相关。我们将使用UFOV作为衡量视觉注意力/认知处理速度的指标，它与IADL高度相关，包括驾驶和撞车风险。尽管可能与UFOV相关，但UFOV尚未用于化疗研究。这项研究将集中在三个年龄段--50岁、51-69岁和70岁及以上，并将 通过化疗的相互作用探索年龄。样本将包括35-50名完成化疗的乳腺癌幸存者，以及35-50名年龄、种族和教育程度匹配的对照组。参与者还将接受其他认知测试，以将这项研究的结果与之前的研究进行比较。将收集驾驶行为、主观神经心理症状、抑郁和积极保护因素的数据，以探索实际缺陷、感知缺陷、保护因素和驾驶行为之间的关系。化疗相关缺陷的发现可能对患者的安全性和独立性很重要 对乳腺癌幸存者的治疗，并可协助设计干预措施。这项研究将为计划一项关于化疗和年龄/化疗交互作用对认知功能影响的明确研究提供关键信息。

This RO3 application addresses the NIA (PAR-02-049) objective, "Cancer in the Elderly" (#7) and is relevant to "Basic research in Behavioral Medicine" (#8), "Cognition in Context" (#12), and "Improved Measures and Methods" (#24). The incidence of breast cancer rises dramatically for post-menopausal women and increases with age. Exposure adjusted crash risk rises with age, and scores on cognitive indicators that are highly associated with important daily activities, such as driving, also tend to decline with age. Chemotherapy is a standard treatment for breast cancer and has been associated with poorer performance on neuropsychological tests. However, effects of chemotherapy on cognitive test performance that is most closely associated with everyday functioning, such as driving, have not been examined nor have interactions between age and chemotherapy on cognitive functioning. We will conduct an innovative pilot study to explore whether chemotherapy for breast cancer is associated with impaired performance on a cognitive test that is highly related to performance of important activities, including driving. We will use as a measure the UFOV, a test of visual attention/cognitive processing speed, that correlates highly with IADLs, including driving as well as crash risk. Despite its possible relevance, the UFOV has not been used in chemotherapy studies. This study will focus on three age groups--< 50, 51-69, and 70 and above and will explore age by chemotherapy interactions. The sample will include 35-50 breast cancer survivors who have completed chemotherapy, and 35-50 age-, race-, and education-matched controls. Participants will also be tested on other cognitive tests to compare findings of this study to previous studies. Data on driving behavior, subjective neuropsychological symptoms, depression and positive protective factors will be collected to explore relationships between actual deficits, perceived deficits, protective factors, and driving behavior. Findings of chemotherapy-associated deficits may be important for the safety and independence of breast cancer survivors and may assist in designing interventions. This study will provide critical information for planning a definitive study of effects of chemotherapy and of age/chemotherapy interactions on cognitive functions.