Cognitive function and patient-reported memory problems after radiotherapy for cancers at the skull base: A cross-sectional survivorship study using the Telephone Interview for Cognitive Status and the MD Anderson Symptom Inventory-Head and Neck Module

Head Neck. 2017 Oct;39(10):2048-2056. doi: 10.1002/hed.24876. Epub 2017 Aug 1.

Abstract

Background: Using patient-reported and objective assessment tools, we sought to quantify cognitive symptoms and objective cognitive dysfunction in patients irradiated for skull base cancer.

Methods: Participants were assessed using the Telephone Interview for Cognitive Status (TICS) and the MD Anderson Symptom Inventory-Head and Neck module (MDASI-HN), with subsequent analysis.

Results: Of the 122 participants analyzed, the majority (63%) had no frank detectable cognitive impairment by TICS, with frank impairment in 6%. Overall, mean patient-reported problems with memory (MDASImemory ) was 3.3 (SD ±2.66). On recursive partition analysis, the MDASImemory cutoff point of ≥5 was associated with detectable cognitive impairment by TICS (logworth 1.69; P = .02), yet no MDASImemory threshold was associated with unambiguous absence of impairment by TICS.

Conclusion: Approximately one third of patients had ambiguous results by TICS assessment, for whom more rigorous testing may be warranted. Moderate to severe levels of patient-reported memory complaints on the MDASI-HN module may have utility as a screening tool for cognitive dysfunction in this population.

Keywords: cognitive impairment; memory; radiotherapy; skull base; symptoms.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Area Under Curve
  • Central Nervous System / radiation effects
  • Cognition
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / epidemiology
  • Cognitive Dysfunction / etiology
  • Cross-Sectional Studies
  • Female
  • Health Status Indicators
  • Humans
  • Interviews as Topic / methods
  • Male
  • Mass Screening / methods
  • Memory Disorders / diagnosis*
  • Memory Disorders / epidemiology
  • Memory Disorders / etiology
  • Middle Aged
  • Patient Reported Outcome Measures
  • Radiation Injuries / diagnosis
  • Severity of Illness Index
  • Skull Base / pathology*
  • Skull Base Neoplasms / radiotherapy*
  • Survivorship
  • Young Adult