Prevalence and influencing factors of cognitive impairment in lung cancer patients undergoing chemotherapy_West China Medical Journal

Authors：

LUO Yu ^1,2 , YANG Xue ^1,2 ,  WANG Li ^2,3

1. West China School of Nursing, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Lung Cancer Center / Lung Cancer Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Medical Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding?author：

WANG Li, Email: wangli37029192@sina.com

Keywords：

Lung neoplasms; cognitive impairment; influencing factor; cross-sectional study

DOI：

10.7507/1002-0179.202412096

Video：

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Objective To investigate the prevalence of cognitive impairment and identify its influencing factors among lung cancer patients undergoing chemotherapy, providing a scientific basis for targeted interventions. Methods A convenience sample of lung cancer patients receiving chemotherapy at West China Hospital, Sichuan University between April and October 2024 was enrolled. Data were collected using a general information questionnaire, the Mini-Mental State Examination, Nutritional Risk Screening 2002, Hospital Anxiety and Depression Scale, Barthel index, and FRAIL scale. Univariate analyses and multivariate logistic regression were performed to determine factors associated with cognitive impairment. Results A total of 380 patients undergoing chemotherapy for lung cancer were enrolled, and 205 (53.9%) of them had cognitive impairment. Univariate analyses revealed that there were statistically significant differences between the cognitively normal group and the cognitive impairment group in age, educational level, work status, nutritional status, Barthel index, and FRAIL scale score (P<0.05). Multivariate logistic regression showed that advanced age [odds ratio (OR)=1.045, 95% confidence interval (CI) (1.015, 1.075), P=0.002] and FRAIL scale score [OR=1.369, 95%CI (1.165, 1.609), P<0.001] were identified as independent risk factors for cognitive impairment, whereas higher educational attainment served as a protective factor, compared with patients with primary school education or below, patients with junior high school, high school/secondary vocational school, college, or undergraduate education and above had a lower risk of cognitive impairment [OR=0.437, 0.258, 0.243, 0.120, P<0.05]. Conclusions Cognitive impairment is highly prevalent among lung cancer patients undergoing chemotherapy and is significantly influenced by age, educational level, and frailty. Healthcare providers should develop targeted interventions based on these factors to reduce the prevalence of cognitive impairment.

Citation： LUO Yu, YANG Xue, WANG Li. Prevalence and influencing factors of cognitive impairment in lung cancer patients undergoing chemotherapy. West China Medical Journal, 2025, 40(5): 722-727. doi: 10.7507/1002-0179.202412096 Copy

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2.	Oliver AL. Lung cancer: epidemiology and screening. Surg Clin North Am, 2022, 102(3): 335-344.
3.	Barta JA, Powell CA, Wisnivesky JP. Global epidemiology of lung cancer. Ann Glob Health, 2019, 85(1): 8.
4.	Howington JA, Blum MG, Chang AC, et al. Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.
5.	Lange M, Joly F, Vardy J, et al. Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors. Ann Oncol, 2019, 30(12): 1925-1940.
6.	Binarelli G, Duivon M, Joly F, et al. Cancer-related cognitive impairment: current perspectives on the management of cognitive changes following cancer treatment. Expert Rev Neurother, 2023, 23(3): 249-268.
7.	Eggen AC, Richard NM, Bosma I, et al. Factors associated with cognitive impairment and cognitive concerns in patients with metastatic non-small cell lung cancer. Neurooncol Pract, 2021, 9(1): 50-58.
8.	Simó M, Root JC, Vaquero L, et al. Cognitive and brain structural changes in a lung cancer population. J Thorac Oncol, 2015, 10(1): 38-45.
9.	Fleming B, Edison P, Kenny L. Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management. BMJ, 2023, 380: e071726.
10.	賀佳, 尹平. 醫學統計學. 2 版. 北京: 高等教育出版社, 2020: 296-297.
11.	丁華, 王堃, 趙忻怡, 等. 老年人認知功能狀況的相關因素. 中國心理衛生雜志, 2022, 36(3): 197-203.
12.	原陳珊, 來云霞. 3 種營養篩查工具在骨與軟組織腫瘤患者營養不良風險評估中的臨床價值. 中國食物與營養, 2024, 30(7): 82-85, 89.
13.	馬瑩, 劉艷軍, 李春燕, 等. 醫院焦慮抑郁量表用于耳鼻咽喉科住院患者心理狀態評估的調查研究. 腫瘤預防與治療, 2020, 33(6): 519-524.
14.	李田園, 潘琦, 張梅, 等. 應用醫院用焦慮抑郁量表探討住院 2 型糖尿病患者焦慮抑郁的發生風險. 中國糖尿病雜志, 2019, 27(9): 671-676.
15.	黃春麗, 張海英, 張琰, 等. “互聯網+延續性護理”對輕度失能老年患者生活質量及家庭照顧者準備度的影響. 中國老年保健醫學, 2024, 22(3): 160-164.
16.	李晨, 江珊, 汪欣, 等. 三種衰弱評估工具對老年慢性心力衰竭患者不良結局預測能力的比較. 中華老年心腦血管病雜志, 2024, 26(10): 1125-1129.
17.	高鵬, 王亮, 王宏宇, 等. 衰弱量表評分及衰弱指數與老年患者髖關節置換術后康復效果的相關性分析. 中國康復醫學雜志, 2024, 39(4): 529-534.
18.	李明妍, 王睿哲, 易瑩瑩, 等. 癌癥病人衰弱評估工具的研究進展. 護理研究, 2024, 38(15): 2723-2727.
19.	郭飛, 高昌俊, 袁方明, 等. 老年肺癌患者術后遠期認知功能及其影響因素調查分析. 現代腫瘤醫學, 2023, 31(7): 1256-1261.
20.	王盼嬌, 韓月, 郜文豪. 肺癌患者化療期間睡眠質量狀況及對策方案的制定與實施效果分析. 黑龍江醫藥, 2024, 37(5): 1232-1234.
21.	李芙蘭, 謝海霞, 于天爽, 等. 肺癌患者化療期間癥狀群的范圍綜述. 中華護理雜志, 2024, 59(18): 2283-2289.
22.	王歡, 張磊. 同步放化療對非小細胞肺癌患者近期療效、肺功能的影響. 現代醫學與健康研究電子雜志, 2024, 8(16): 64-66.
23.	蘇崇玉, 王宇軒, 史抗, 等. 老年肺癌患者全身麻醉胸腔鏡手術術后發生認知功能障礙的影響因素分析. 中國醫刊, 2024, 59(6): 627-630.
24.	Hou T, Peng W, Ho MH, et al. Factors associated with cancer-related cognitive impairment in patients with lung cancer: a systematic review. Eur J Oncol Nurs, 2024, 71: 102657.
25.	歐陽筱瑤, 李戰勝, 孫舒悅, 等. 健康生態學視角下社區老年 2 型糖尿病患者輕度認知障礙現狀及影響因素分析. 華南預防醫學, 2023, 49(7): 828-833.
26.	陳玲, 楊連招, 陸靜鈺, 等. 南寧市社區老年高血壓患者輕度認知障礙現狀及影響因素研究. 中華護理教育, 2022, 19(6): 566-571.
27.	徐盼, 王樂, 張園, 等. 老年性聾患者的認知功能影響因素探究. 中華耳科學雜志, 2023, 21(1): 69-75.
28.	羅琴, 石強, 龔清平, 等. 不同類型睡眠障礙對帕金森病患者認知功能的影響分析. 中國臨床神經科學, 2022, 30(5): 575-580.
29.	董凱生, 陶香君, 王穎, 等. 首發腦梗死患者急性期血管性認知功能障礙的影響因素分析. 中國病案, 2024, 25(6): 103-106.
30.	連周燕, 杜影. 上海市社區老年人牙列狀態及其與衰弱和認知功能的關系. 中國初級衛生保健, 2024, 38(9): 35-38.
31.	趙璨, 劉姍姍, 李凈兵, 等. 老年高血壓伴衰弱患者認知功能障礙的危險因素及與不良預后的關系. 心血管康復醫學雜志, 2024, 33(4): 391-394.

1. Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin, 2024, 74(1): 12-49.
2. Oliver AL. Lung cancer: epidemiology and screening. Surg Clin North Am, 2022, 102(3): 335-344.
3. Barta JA, Powell CA, Wisnivesky JP. Global epidemiology of lung cancer. Ann Glob Health, 2019, 85(1): 8.
4. Howington JA, Blum MG, Chang AC, et al. Treatment of stage I and II non-small cell lung cancer: diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest, 2013, 143(5 Suppl): e278S-e313S.
5. Lange M, Joly F, Vardy J, et al. Cancer-related cognitive impairment: an update on state of the art, detection, and management strategies in cancer survivors. Ann Oncol, 2019, 30(12): 1925-1940.
6. Binarelli G, Duivon M, Joly F, et al. Cancer-related cognitive impairment: current perspectives on the management of cognitive changes following cancer treatment. Expert Rev Neurother, 2023, 23(3): 249-268.
7. Eggen AC, Richard NM, Bosma I, et al. Factors associated with cognitive impairment and cognitive concerns in patients with metastatic non-small cell lung cancer. Neurooncol Pract, 2021, 9(1): 50-58.
8. Simó M, Root JC, Vaquero L, et al. Cognitive and brain structural changes in a lung cancer population. J Thorac Oncol, 2015, 10(1): 38-45.
9. Fleming B, Edison P, Kenny L. Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management. BMJ, 2023, 380: e071726.
10. 賀佳, 尹平. 醫學統計學. 2 版. 北京: 高等教育出版社, 2020: 296-297.
11. 丁華, 王堃, 趙忻怡, 等. 老年人認知功能狀況的相關因素. 中國心理衛生雜志, 2022, 36(3): 197-203.
12. 原陳珊, 來云霞. 3 種營養篩查工具在骨與軟組織腫瘤患者營養不良風險評估中的臨床價值. 中國食物與營養, 2024, 30(7): 82-85, 89.
13. 馬瑩, 劉艷軍, 李春燕, 等. 醫院焦慮抑郁量表用于耳鼻咽喉科住院患者心理狀態評估的調查研究. 腫瘤預防與治療, 2020, 33(6): 519-524.
14. 李田園, 潘琦, 張梅, 等. 應用醫院用焦慮抑郁量表探討住院 2 型糖尿病患者焦慮抑郁的發生風險. 中國糖尿病雜志, 2019, 27(9): 671-676.
15. 黃春麗, 張海英, 張琰, 等. “互聯網+延續性護理”對輕度失能老年患者生活質量及家庭照顧者準備度的影響. 中國老年保健醫學, 2024, 22(3): 160-164.
16. 李晨, 江珊, 汪欣, 等. 三種衰弱評估工具對老年慢性心力衰竭患者不良結局預測能力的比較. 中華老年心腦血管病雜志, 2024, 26(10): 1125-1129.
17. 高鵬, 王亮, 王宏宇, 等. 衰弱量表評分及衰弱指數與老年患者髖關節置換術后康復效果的相關性分析. 中國康復醫學雜志, 2024, 39(4): 529-534.
18. 李明妍, 王睿哲, 易瑩瑩, 等. 癌癥病人衰弱評估工具的研究進展. 護理研究, 2024, 38(15): 2723-2727.
19. 郭飛, 高昌俊, 袁方明, 等. 老年肺癌患者術后遠期認知功能及其影響因素調查分析. 現代腫瘤醫學, 2023, 31(7): 1256-1261.
20. 王盼嬌, 韓月, 郜文豪. 肺癌患者化療期間睡眠質量狀況及對策方案的制定與實施效果分析. 黑龍江醫藥, 2024, 37(5): 1232-1234.
21. 李芙蘭, 謝海霞, 于天爽, 等. 肺癌患者化療期間癥狀群的范圍綜述. 中華護理雜志, 2024, 59(18): 2283-2289.
22. 王歡, 張磊. 同步放化療對非小細胞肺癌患者近期療效、肺功能的影響. 現代醫學與健康研究電子雜志, 2024, 8(16): 64-66.
23. 蘇崇玉, 王宇軒, 史抗, 等. 老年肺癌患者全身麻醉胸腔鏡手術術后發生認知功能障礙的影響因素分析. 中國醫刊, 2024, 59(6): 627-630.
24. Hou T, Peng W, Ho MH, et al. Factors associated with cancer-related cognitive impairment in patients with lung cancer: a systematic review. Eur J Oncol Nurs, 2024, 71: 102657.
25. 歐陽筱瑤, 李戰勝, 孫舒悅, 等. 健康生態學視角下社區老年 2 型糖尿病患者輕度認知障礙現狀及影響因素分析. 華南預防醫學, 2023, 49(7): 828-833.
26. 陳玲, 楊連招, 陸靜鈺, 等. 南寧市社區老年高血壓患者輕度認知障礙現狀及影響因素研究. 中華護理教育, 2022, 19(6): 566-571.
27. 徐盼, 王樂, 張園, 等. 老年性聾患者的認知功能影響因素探究. 中華耳科學雜志, 2023, 21(1): 69-75.
28. 羅琴, 石強, 龔清平, 等. 不同類型睡眠障礙對帕金森病患者認知功能的影響分析. 中國臨床神經科學, 2022, 30(5): 575-580.
29. 董凱生, 陶香君, 王穎, 等. 首發腦梗死患者急性期血管性認知功能障礙的影響因素分析. 中國病案, 2024, 25(6): 103-106.
30. 連周燕, 杜影. 上海市社區老年人牙列狀態及其與衰弱和認知功能的關系. 中國初級衛生保健, 2024, 38(9): 35-38.
31. 趙璨, 劉姍姍, 李凈兵, 等. 老年高血壓伴衰弱患者認知功能障礙的危險因素及與不良預后的關系. 心血管康復醫學雜志, 2024, 33(4): 391-394.

West China Medical Journal

Prevalence and influencing factors of cognitive impairment in lung cancer patients undergoing chemotherapy

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