The aim of this exploratory study is to assess the cognitive effects of chemotherapy (CT) in women with breast cancer and to understand the role of age and cognitive reserve (CR) in the development of these effects.
A group of women with early breast cancer with indication for CT (n = 32) and a group of healthy subjects (n = 32) were recruited. Both groups performed neuropsychological assessment at two time points- at baseline (before the initiation of CT and 6 months later). Additionally, Cognitive Reserve Index questionnaire (CRIq), a comprehensive measure of CR, was applied. The cognitive tests were combined in a unique z-score for attention and executive function domain. The longitudinal cognitive assessment was analyzed using a mixed effect modeling approach with patient’s vs controls as grouping factor and adjusted for age, CR, years of education and baseline cognitive performance as fixed factors.
Mean age and education years for both groups were 49 (SD ± 8) years and 17 (SD ± 3), respectively. The level of CR was equally distributed across both samples, with 75% of participants presenting a high level of CR. The mixed effects model analysis did not show a significant effect for group. For Attention, a three-way interaction among CR, age and years of education was significant (p = 0.04). For the executive functions, none of the factors were significant.
Our results suggest that CT did not contribute significantly for the development of cognitive decline in cancer patients. However, age, years of education and CR have a joint impact on attention, but not executive functions.

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