Article

Positive and negative affect, depression, and cognitive processes in the Cognition in the Study of Tamoxifen and Raloxifene (Co-STAR) Trial

a Wake Forest School of Medicine , Winston-Salem , NC , USA.
Aging Neuropsychology and Cognition (Impact Factor: 1.07). 12/2012; 20(5). DOI: 10.1080/13825585.2012.747671
Source: PubMed

ABSTRACT

Objectives:
This study examined the relationship between positive and negative affect, depressive symptoms, and cognitive performance.

Methods:
The sample consisted of 1479 non-demented, postmenopausal women (mean age = 67 years) at increased risk of breast cancer enrolled in the National Surgical Adjuvant Breast and Bowel Project's Study of Tamoxifen and Raloxifene. At each annual visit, women completed a standardized neuropsychological battery and self-report measures of affect and depression. Data from three visits were used in linear mixed models for repeated measures using likelihood ratio tests. Separate analyses were performed to relate positive/negative affect and depression to each cognitive measure.

Results:
Higher positive affect was associated with better letter fluency (p = .006) and category fluency (p < .0001). Higher negative affect was associated with worse global cognitive function (p < .0001), verbal memory (CVLT List B; p = .002), and spatial ability (p < .0001). Depressive symptoms were negatively associated with verbal knowledge (p = .004), figural memory (p < .0001), and verbal memory (p's ≤ .0001).

Discussion:
Findings are consistent with some prior research demonstrating a link between positive affect and increased verbal fluency and between depressive symptoms and decreased memory. The most novel finding shows that negative affect is related to decreased global cognition and visuospatial ability. Overall, this research in a large, longitudinal sample supports the notion that positive affect is related to increases and negative affect to decreases in performance on distinct cognitive measures.

1 Follower
 · 
25 Reads
  • [Show abstract] [Hide abstract]
    ABSTRACT: We examined how positive and negative social exchanges with friends, family, and spouses were related to cognitive aging in episodic and working memory, and perceptual speed. To do so, we used a large sample of cognitively intact young-old participants from the PATH Through Life Study (PATH; aged 60 to 64 years at baseline, n = 1,618) who were assessed on 3 occasions over 8 years. Additional replication analyses were conducted using the Health and Retirement Study (HRS), which provided data on episodic memory. The main analysis of PATH Through Life showed that positive exchanges with friends and family were associated with less decline in perceptual speed, with these associations attenuated by adjustment for physical functioning and depressive symptoms. Negative exchanges with spouses were associated with poorer working memory performance. Positive exchanges with friends were associated with better initial episodic memory in both PATH and HRS. More frequent negative exchanges with friends and family were associated with better episodic memory in the PATH sample. However, these findings were not replicated in HRS. Our findings provide indirect support for the role of social exchange quality in contributing to cognitive enrichment. However, the inconsistent pattern of results across cognitive and social exchange domains points to possibilities of reverse causality, and may also indicate that social exchange quality plays a less important role for cognitive enrichment than other psychosocial characteristics. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    No preview · Article · Mar 2014 · Psychology and Aging
  • [Show abstract] [Hide abstract]
    ABSTRACT: Cognitive impairment, especially verbal episodic memory and executive function impairments, has been considered to be a possible adverse effect of aromatase inhibitors (AI). This phase III open-label study compared the impact of tamoxifen and AI on verbal episodic memory (Rey auditory verbal learning test-RAVLT) and other cognitive functions (visual memory, psychomotor speed, and executive functions) after 6 and 12 months of treatment in breast cancer patients undergoing adjuvant hormonotherapy. Menopausal chemo-naïve patients with resectable breast cancer were randomly assigned (1:1) at the end of the radiotherapy to receive tamoxifen or AI. Neuropsychological assessments, self-reported quality of life, and depression assessments were performed at baseline, before any hormonal treatment, and at 6 and 12 months. Mixed design analysis models of variance was used to compare the evolution of the scores between the groups during follow-up. A total of 74 evaluable patients were enrolled (Tamoxifen arm, n = 37; AI arm, n = 37; letrozole n = 18; anastrozole n = 16; exemestane n = 3). The median age at inclusion was 61 years (range, minimum 49-maximum 69). The patient and breast cancer characteristics were well balanced between arms. After 6 months, no significant differential effect of AI or tamoxifen was observed on the RAVLT. Moreover, considering the other cognitive measures and the quality of life questionnaires, there were also no differences between the groups during the 1-year follow-up. In this study, AI has not demonstrated worse adverse effects on cognitive functions than tamoxifen during a 1-year follow-up.
    No preview · Article · Jul 2015 · Breast Cancer Research and Treatment
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background and objective: The purpose of the present review was to study the impact of endocrine therapy (ET) on the cognitive outcomes of breast cancer patients. Materials and methods: We systematically searched the literature using the MEDLINE (1966-2015), Scopus (2004-2015), ClinicalTrials.gov (2008-2015) and Cochrane Central Register (CENTRAL) databases, as well as the references of the electronically retrieved articles. Results: Twelve studies were included in the present systematic review, which assessed the cognitive function of 2756 patients. Among these patients, 2381 received ET, whereas the remaining 375 served as controls (placebo or no therapy). The majority of patients were postmenopausal, and the minimum follow-up period was 3 months and the maximum 2 years. Treatment with ET seems to be accompanied by altered cognitive abilities, including verbal memory, verbal fluency, motor speed, attention and working memory. Tamoxifen seems to be related to decreased cognitive performances compared with treatment with an aromatase inhibitor. Conclusions: ET among breast cancer patients seems to negatively alter the cognitive outcomes of breast cancer patients. However, the methodological heterogeneity of the included studies, as well as the relatively small follow-up period, render imperative the conduct of further studies in the field.
    No preview · Article · Nov 2015 · Clinical Drug Investigation