Journal Article

DKFZ-2023-00945

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis.

Hiensch, A. E. ; Beckhaus, J. ; Witlox, L. ; Monninkhof, E. M. ; Schagen, S. B. ; van Vulpen, J. K. ; Sweegers, M. G. ; Newton, R. U. ; Aaronson, N. K. ; Galvão, D. A. ; Steindorf, K.DKFZ* ; Stuiver, M. M. ; Mesters, I. ; Knoop, H. ; Goedendorp, M. M. ; Bohus, M. ; Thorsen, L. ; Schulz, K.-H. ; Schmidt, M. E.DKFZ* ; Ulrich, C. M. ; Sonke, G. S. ; van Harten, W. H. ; Winters-Stone, K. M. ; Velthuis, M. J. ; Taaffe, D. R. ; van Mechelen, W. ; Kersten, M. J. ; Nollet, F. ; Wiskemann, J. ; Buffart, L. M. ; May, A. M.

2024
Springer New York, NY [u.a.]

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Please use a persistent id in citations: doi:DOI: 10.1007/s11764-023-01392-3  doi:DOI: 10.1007/s11764-023-01392-3

Abstract: This individual participant data meta-analysis (IPD-MA) assesses exercise effects on self-reported cognitive functioning (CF) and investigates whether effects differ by patient-, intervention-, and exercise-related characteristics.IPD from 16 exercise RCTs, including 1987 patients across multiple types of non-metastatic cancer, was pooled. A one-stage IPD-MA using linear mixed-effect models was performed to assess exercise effects on self-reported CF (z-score) and to identify whether the effect was moderated by sociodemographic, clinical, intervention- and exercise-related characteristics, or fatigue, depression, anxiety, and self-reported CF levels at start of the intervention (i.e., baseline). Models were adjusted for baseline CF and included a random intercept at study level to account for clustering of patients within studies. A sensitivity analysis was performed in patients who reported cognitive problems at baseline.Minimal significant beneficial exercise effects on self-reported CF (β=-0.09 [-0.16; -0.02]) were observed, with slightly larger effects when the intervention was delivered post-treatment (n=745, β=-0.13 [-0.24; -0.02]), and no significant effect during cancer treatment (n=1,162, β=-0.08 [-0.18; 0.02]). Larger effects were observed in interventions of 12 weeks or shorter (β=-0.14 [-0.25; -0.04]) or 24 weeks or longer (β=-0.18 [-0.32; -0.02]), whereas no effects were observed in interventions of 12-24 weeks (β=0.01 [-0.13; 0.15]). Exercise interventions were most beneficial when provided to patients without anxiety symptoms (β=-0.10 [-0.19; -0.02]) or after completion of treatment in patients with cognitive problems (β=-0.19 [-0.31; -0.06]). No other significant moderators were identified.This cross-cancer IPD meta-analysis observed small beneficial exercise effects on self-reported CF when the intervention was delivered post-treatment, especially in patients who reported cognitive problems at baseline.This study provides some evidence to support the prescription of exercise to improve cognitive functioning. Sufficiently powered trials are warranted to make more definitive recommendations and include these in the exercise guidelines for cancer survivors.

Keyword(s): Cancer ; Cognitive functioning ; Exercise ; Individual participant data meta-analysis ; Survivorship

Note: 2024 Oct;18(5):1492-1503

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Contributing Institute(s):

1. Bewegung, Präventionsforschung und Krebs (C110)

Research Program(s):

1. 313 - Krebsrisikofaktoren und Prävention (POF4-313) (POF4-313)

Appears in the scientific report 2023

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Social and Behavioral Sciences ; DEAL Springer ; DEAL Springer ; Essential Science Indicators ; IF < 5 ; JCR ; SCOPUS ; Science Citation Index Expanded ; Social Sciences Citation Index ; Web of Science Core Collection

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