TY - JOUR
T1 - Moderators of exercise effects on self-reported cognitive functioning in cancer survivors: an individual participant data meta-analysis
AU - Hiensch, Anouk E.
AU - Beckhaus, Julia
AU - Witlox, Lenja
AU - Monninkhof, Evelyn M.
AU - Schagen, Sanne B.
AU - van Vulpen, Jonna K.
AU - Sweegers, Maike G.
AU - Newton, Robert U.
AU - Aaronson, Neil K.
AU - Galvao, Daniel A.
AU - Steindorf, Karen
AU - Stuiver, Martijn M.
AU - Mesters, Ilse
AU - Knoop, Hans
AU - Goedendorp, Martine M.
AU - Bohus, Martin
AU - Thorsen, Lene
AU - Schulz, Karl-Heinz
AU - Schmidt, Martina E.
AU - Ulrich, Cornelia M.
AU - Sonke, Gabe S.
AU - van Harten, Wim H.
AU - Winters-Stone, Kerri M.
AU - Velthuis, Miranda J.
AU - Taaffe, Dennis R.
AU - van Mechelen, Willem
AU - Kersten, Marie Jose
AU - Nollet, Frans
AU - Wiskemann, Joachim
AU - Buffart, Laurien M.
AU - May, Anne M.
PY - 2023/5/1
Y1 - 2023/5/1
N2 - PurposeThis 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.MethodsIPD 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.ResultsMinimal significant beneficial exercise effects on self-reported CF (beta=-0.09 [-0.16; -0.02]) were observed, with slightly larger effects when the intervention was delivered post-treatment (n=745, beta=-0.13 [-0.24; -0.02]), and no significant effect during cancer treatment (n=1,162, beta=-0.08 [-0.18; 0.02]). Larger effects were observed in interventions of 12 weeks or shorter (beta=-0.14 [-0.25; -0.04]) or 24 weeks or longer (beta=-0.18 [-0.32; -0.02]), whereas no effects were observed in interventions of 12-24 weeks (beta=0.01 [-0.13; 0.15]). Exercise interventions were most beneficial when provided to patients without anxiety symptoms (beta=-0.10 [-0.19; -0.02]) or after completion of treatment in patients with cognitive problems (beta=-0.19 [-0.31; -0.06]). No other significant moderators were identified.ConclusionsThis 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.Implications for Cancer SurvivorsThis 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.
AB - PurposeThis 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.MethodsIPD 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.ResultsMinimal significant beneficial exercise effects on self-reported CF (beta=-0.09 [-0.16; -0.02]) were observed, with slightly larger effects when the intervention was delivered post-treatment (n=745, beta=-0.13 [-0.24; -0.02]), and no significant effect during cancer treatment (n=1,162, beta=-0.08 [-0.18; 0.02]). Larger effects were observed in interventions of 12 weeks or shorter (beta=-0.14 [-0.25; -0.04]) or 24 weeks or longer (beta=-0.18 [-0.32; -0.02]), whereas no effects were observed in interventions of 12-24 weeks (beta=0.01 [-0.13; 0.15]). Exercise interventions were most beneficial when provided to patients without anxiety symptoms (beta=-0.10 [-0.19; -0.02]) or after completion of treatment in patients with cognitive problems (beta=-0.19 [-0.31; -0.06]). No other significant moderators were identified.ConclusionsThis 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.Implications for Cancer SurvivorsThis 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.
KW - Cancer
KW - Cognitive functioning
KW - Exercise
KW - Individual participant data meta-analysis
KW - Survivorship
KW - QUALITY-OF-LIFE
KW - RANDOMIZED CONTROLLED-TRIAL
KW - ANDROGEN DEPRIVATION THERAPY
KW - INCREASING PHYSICAL-ACTIVITY
KW - PROSTATE-CANCER
KW - ADJUVANT CHEMOTHERAPY
KW - AEROBIC EXERCISE
KW - HIGH-INTENSITY
KW - FATIGUE
KW - RESISTANCE
U2 - 10.1007/s11764-023-01392-3
DO - 10.1007/s11764-023-01392-3
M3 - Article
C2 - 37160571
SN - 1932-2259
JO - Journal of Cancer Survivorship-Research and Practice
JF - Journal of Cancer Survivorship-Research and Practice
ER -