Factors associated with perceived cognitive impairment in patients with advanced lung cancer: a cross-sectional analysis

Purpose: Perceived cognitive impairment refers to cognitive dysfunction that particularly involves impairment in working or short-term memory, and inattention. This study aimed to identify factors associated with perceived cognitive impairment in patients with advanced lung cancer. Methods: This cross-sectional analysis used pooled data from a prospective, ongoing randomized controlled trial examining the effectiveness of exercise in patients with advanced lung cancer (Trial Registration: NCT04119778). Patients diagnosed with stage IIIB or IV non-small cell lung cancer were recruited from three public hospitals in Hong Kong between December 2018 and December 2021. Demographics, daily step count, sleep quality, fatigue, depression, anxiety, and perceived cognitive impairment were included in the analyses. Multivariate logistic regression analysis was used to determine the most critical risk factors associated with perceived cognitive impairments in attention and memory. Results: A total of 226 patients were included and analyzed, 35.4% of patients had perceived attention impairment and 58.4% had perceived memory impairment. The daily step count (adjusted odds ratio [aOR] = 0.496; confidence interval [CI] = 0.258–0.954), fatigue (aOR = 1.342; CI = 1.903–1.648), and anxiety (aOR = 1.179; CI = 1.042–1.335) were associated with a significantly increased risk of perceived attention impairment, while anxiety (aOR = 1.126; CI = 1.008–1.257) was identified as the most significant factor for perceived memory impairment. Conclusion: The findings of this study can inform the design of effective interventions to reduce perceived cognitive impairment and promote the quality of life and well-being of patients with advanced lung cancer.