ArticleJournal of cancer survivorship : research and practice2024
The impact of APOE and smoking history on cognitive function in older, long-term breast cancer survivors.
Article in Journal of cancer survivorship : research and practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 8 citations in OpenAlex.
- Apolipoprotein E DNA Methylation Linked to Cognitive Decline in Postmenopausal Women With Breast Cancer.Molecular genetics & genomic medicine · 2026Observational
- Cancer treatment-related cognitive impairment.Neuro-oncology advances · 2026Review
- Interaction of endocrine therapy for breast cancer with APOE4 status on cognition over 5-year follow-up.JNCI cancer spectrum · 2026Article
- Alterations in Brain White Matter Tractography in Older Long-Term Breast Cancer Survivors Treated with Chemotherapy.Brain sciences · 2026Article
- Interaction between APOE Ɛ4 status, chemotherapy and endocrine therapy on cognitive functioning among breast cancer survivors: the CANTO-Cog longitudinal study.Breast cancer research : BCR · 2025Article
- Cognitive function is mediated by deficit accumulation in older, long-term breast cancer survivors.Journal of cancer survivorship : research and practice · 2024Article
- Brain white matter microstructural changes in chemotherapy-treated older long-term breast cancer survivors.Cancer medicine · 2024Article
- The role ofFrontiers in immunology · 2024Article
- Cognitive Aging in Older Breast Cancer Survivors.Cancers · 2023Article
- GSK3β rs3107669 polymorphism implicates chemotherapy-associated retrospective memory deficits in breast cancer survivors.American journal of cancer research · 2023Article
Corrections and comments
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Authors and funding
16 authors at 2 institutions in 1 country.
Funding
Abstract
purposeThis study aims to determine whether older breast cancer survivors score lower on neuropsychological tests compared to matched non-cancer controls and to test the hypotheses that survivors who were APOE ε4 carriers would have the lowest cognitive performance but that smoking history would decrease the negative effect of ε4 on cognition.
methodsFemale breast cancer survivors who had been diagnosed and treated at age 60 or older and were 5-15-year survivors (N = 328) and age and education matched non-cancer controls (N = 162) were assessed at enrollment and at 8-, 16-, and 24-month follow-ups with standard neuropsychological and psychological assessments. Blood for APOE genotyping was collected, and smoking history was assessed at enrollment. Participants were purposely recruited so that approximately 50% had a history of treatment with chemotherapy or no chemotherapy and approximately 50% had a smoking history.
resultsAfter adjusting for age, cognitive reserve, depression, and fatigue, breast cancer survivors scored significantly lower on all domains of cognitive function. A significant two-way interaction demonstrated that the negative effect of ε4 on cognitive performance was stronger among survivors. A significant three-way interaction supported the hypothesis that smoking history had a protective effect on cognitive function in ε4 carriers that was more pronounced in the controls than the survivors.
conclusionsThe results support the long-term cognitive impact of breast cancer diagnosis and treatments on older, disease-free survivors, particularly for ε4 carriers. The results also emphasize the importance of assessing smoking history when examining APOE and cognition and are an example of the complex interactions of age, genetics, health behaviors, and disease history in determining cognitive function. IMPLICATIONS FOR CANCER SURVIVORS: These results help explain why only a subset of breast cancer survivors appear to be vulnerable to cognitive problems.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.