About this Research Topic

Background

Changes in cognition due to cancer have received increased attention in clinical research due to the significant impacts on daily functioning and quality of life reported by patients and survivors. Evidence suggests up to 75% of patients experience cancer-associated cognitive decline (CACD) during treatment, with over 45% experiencing clinically significant decline pre- to post-treatment. The cognitive processes affected include those that are known to decline with normal cognitive aging, such as executive function, memory, attention, and processing speed. Evidence also indicates changes in brain regions and networks that correspond with these cognitive processes (e.g., hippocampus, prefrontal cortex, default mode network, executive control network). Unfortunately, cancer survivors often experience these neurocognitive changes across a relatively short time period compared to adults without a history of cancer, who experience these changes across their adult lifespan. Cognitive decline may lead to a cascade of physical, psychological, social, and behavioral difficulties; thus, cognitive functioning is considered an essential component of successful aging.

There is a critical need to identify effective prevention strategies and treatments for CACD. Consistent with a more established body of literature in aging, emerging evidence in cancer suggests that physical activity and exercise training may benefit cognition and brain health in cancer populations. As this area of research is relatively young, a number of knowledge gaps exist. First and foremost, few fully-powered studies with cognition as a primary outcome have been conducted, resulting in limited evidence of efficacy. Additionally, there is vast heterogeneity in the definitions and measurement of cognition. Conversely, target populations have been quite homogeneous, with much of the evidence derived in breast cancer followed by prostate cancer. Further, insufficient data are available to inform exercise prescriptions (i.e., frequency, intensity, time, type), optimal timing of interventions, and for whom physical activity may be most beneficial in relation to cognitive health. Finally, how activity behaviors interact with each other (e.g., sitting, low-intensity, high-intensity) and other CACD risk factors (e.g., treatment(s) received, genetics, age, fatigue, depression, sleep, cardiovascular health) remains largely unexplored.

This Research Topic aims to gather research to deepen our understanding of the neurocognitive effects of physical activity in cancer populations. Basic and clinical studies, mechanistic studies, quantitative and qualitative studies, and systematic reviews that would build knowledge in this field are welcome. Additionally, we define physical activity loosely to include studies focused on traditional and alternative modes of exercise, non-exercise and lifestyle physical activity, and sedentary behavior. Likewise, assessment of cognition is not limited to standard neuropsychological tests, but may also include novel methods of cognitive assessment, patient-reported cognition, or neurobiological/neurophysiological measures.

Keywords: cancer-associated cognitive change, cancer-related cognitive impairment, exercise oncology, physical activity, brain health, cognitive function, non-pharmacological interventions for cognitive impairment

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