Study: Is there a link between exercise and memory in breast cancer survivors?


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People diagnosed with early stage breast cancer

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Exercise has many health benefits, but can it also help improve memory for breast cancer survivors? This research finds that breast cancer survivors who exercised more had less fatigue and distress (anxiety, depression, stress, and/or concern about recurrence) and scored better on memory tests. (8/2/16)

Contents

At a glance                  Guidelines
Findings               In-depth                
Clinical trials Limitations
Questions for your doctor Resources and references


STUDY AT A GLANCE

This study is about:

Whether exercise helps memory impairment in breast cancer survivors.

Why is this study important?

Breast cancer survivors frequently report experiencing memory impairment, which is linked to depression, anxiety, and fatigue. In this study, the researchers wanted to know how exercise is related to memory impairment, and its effects in breast cancer survivors.

Study findings: 

  1. Breast cancer survivors who exercised more had less fatigue and distress (anxiety, depression, stress, and/or concern about recurrence) and scored better on memory tests.

What does this mean for me?

The researchers propose a model where more exercise leads to less fatigue and distress, which results in less memory impairment for breast cancer survivors. More work needs to be done to confirm the link between exercise and memory impairment.

Exercise provides many health benefits. According to the Centers for Disease Control (CDC), exercise helps people to reduce their risk of cardiovascular disease and type 2 diabetes, reduce their risk for some cancers, increase their chances of living longer, and strengthen bones and muscles, among other things. Breast cancer survivors experiencing memory impairment and its associated distress and fatigue should talk to their health care providers to see what other things they can do to improve their symptoms.

Expert Guidelines

The National Comprehensive Cancer Network sets recommendations on weight management, nutrition and physical activity for cancer survivors. General principles of physical activity include: 

  • Physical activity and exercise recommendations should be tailored to the individual survivor’s abilities and preferences
  • Physical activity for cancers survivors:
    • Overall volume of weekly activity sould be at least 150-300 minutes of moderate-intensity activity or 75 minutes of vigorous activity or equivalent combination spread out over the course of the week
    • Two to three sessions per week of strength/resistance training that include major muscle groups
    • Stretch major muscle groups at least two days per week
  • Engage in general physical activity daily (eg. Taking the stairs, parking in the back of parking lot)
    • physical activity includes exercise, daily routine activities, and recreational activities
  • Avoid prolonged sedentary behavior (eg. Sitting for long periods)

Questions To Ask Your Health Care Provider

  • I am a breast cancer survivor. Which type of health care provider can I see for follow up survivorship care?
  • How often and how long should I exercise?
  • Are there any exercises I should avoid?
  • What are other things I can do to help improve anxiety, depression, and/or fatigue after breast cancer?
  • Can you refer me to a personal trainer?

Open Clinical Trials

IN DEPTH REVIEW OF RESEARCH

Study background:

Cancer survivors experience a number of long-term side effects that can range from physical problems to psychological and emotional issues. Researchers previously studied how memory impairment affects anxiety, depression and fatigue in breast cancer survivors. In this study, they looked at how lifestyle choices such as regular exercise affect memory impairment and the symptoms associated with it.

In the July 2016 edition of the journal Psycho-Oncology, Siobhan Phillips and her colleagues from Northwestern University and the University of Illinois Urbana Champaign published their work about the relationship between exercise and memory impairment.   

Researchers of this study wanted to know:

Can exercise help ease the symptoms associated with memory impairment (fatigue, anxiety, and/or depression) for breast cancer survivors?

Population(s) looked at in the study:

The study followed 1477 women. The women were at least 18-years-old, had been diagnosed with breast cancer, were English speaking, and had completed treatment for their cancer. The majority of the women were white (about 97%) and were diagnosed with ductal carcinoma in situ (DCIS) or early-stage (stage 1 or stage II) disease.  

When women enrolled in the study they took surveys that evaluated their level of physical activity, distress, fatigue, and memory impairment. They then took the same survey 6 months later. A random subset of the participants wore accelerometers to measure their activity.

Study findings: 

  1. Breast cancer survivors who exercised more had less fatigue and distress (anxiety, depression, stress, and/or concern about recurrence) and scored better on memory tests.
    • Breast cancer survivors who exercised more had higher “exercise self-efficacy” meaning they believed that they would be able to exercise either three or five times each week.
    • Breast cancer survivors who had high exercise efficacy had lower levels of fatigue and distress (depression, concerns about recurrence, perceived stress, anxiety).
    • Breast cancer survivors who had low fatigue and distress scored higher on the Frequency of Forgetting test (which included questions such as where participants had put things, directions, and names), meaning they had less memory impairment than women who had high fatigue and distress.

Limitations:

The study population of this research study was mostly white (about 97%), highly educated and had high annual household income. Because of this, the results of this study may not hold true for all women. Additionally, the researchers only had one follow-up after 6 months. More work should be done to extend this time period.

Memory impairment can also be affected by many factors in addition to exercise, so more work should be done to include diet and other psychosocial factors.

Finally, because this study used participants’ self-reported results, their reporting could be biased. Future studies should be done that include objective measures of cognitive functioning (the researchers only looked at the relationships between exercise and anxiety/fatigue, and the relationship between anxiety/fatigue and memory impairment—they did not look at cognitive function directly after exercise). Additionally, among women who had less fatigue/anxiety, it was not determined whether that was because they exercised more.

Conclusions:

The results of this study suggest that exercise may be beneficial for memory impairment in breast cancer survivors. More work needs to be done to study this relationship; however, breast cancer survivors who are not exercising should work with a health care professional to create an exercise plan, as there are many established benefits to exercising.

Posted 8/2/16

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