Loneliness as a risk factor for cancer-related cognitive impairment: a secondary data analysis from the Haze study

Abstract

Purpose

The purpose of this study was to investigate the association between loneliness and cancer-related cognitive impairment (CRCI) in a cohort of breast cancer survivors.

Methods

Female breast cancer survivors (stage I–III) reporting cognitive impairments 2 months to 5 years after chemotherapy (n = 61) participated in a prospective, nonblinded, waitlist-controlled pilot study. The intervention was a tailored cognitive rehabilitation program. Data were collected pre-/post-intervention. Loneliness was measured using the UCLA Loneliness Scale. Perceived cognitive function was measured using two subscales of the FACT-Cog and two PROMIS – Applied Cognition short forms. Spearman correlation coefficients were calculated to determine the relationship between loneliness and perceived cognitive function (PCF).

Results

Participants’ loneliness severity was correlated with diminished PCF across all cognitive measures (Spearman r= −0.63 FACT-Cog Perceived Cognitive Impairment, p < 0.0001; r= −0.6 FACT-Cog Perceived Cognitive Abilities, p < 0.0001; r= −0.49 PROMIS Cognitive Ability, p = 0.0002; r = 0.50 PROMIS General Concerns, p = 0.0002). Loneliness scores significantly decreased following participation in the cognitive rehabilitation program in intervention participants as compared to wait-list controls [−5.0 ± 7.24, 95% CI (−8.06, −1.94), p = 0.0025].

Conclusions

Perceived loneliness was significantly and consistently correlated with PCF. The intervention may have served a dual purpose in both addressing cognitive deficits and loneliness. Additional research dedicated to understanding the association between loneliness and cognitive function, as well as screening for and addressing loneliness in clinical oncology settings, may be warranted.

IMPLICATIONS FOR REHABILITATION

• Screening for and addressing loneliness in oncology rehabilitation settings is warranted.

• Rehabilitation professionals are well-positioned to screen for and address loneliness during clinic visits as part of routine cancer rehabilitation care.

• Group settings may be appropriate for addressing cancer-related cognitive impairment in rehabilitation, as these groups may serve the dual purpose of addressing cognitive impairment and loneliness simultaneously.

Keywords:

• Loneliness
• cancer
• oncology
• cognitive impairment
• cancer rehabilitation
• cognitive rehabilitation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported in part by the Tower Cancer Research Foundation [grant no. CSR209500 to A.A. and M.-Y.J.] and the Samuel Oschin Comprehensive Cancer Institute at Cedars-Sinai Medical Center.