Cognitive Impairment in Candidates for Allogeneic Hematopoietic Stem Cell Transplantation.

Hematopoietic cell transplant (HCT) is an increasingly common and curative treatment strategy to improve survival among individuals malignant and nonmalignant diseases, with over one million HCTs having been performed worldwide. Neurocognitive dysfunction is a common and untoward consequence of HCT for many recipients, although few studies have examined the profile of neurocognitive impairments in HCT or their association with clinical features, such as frailty. We examined the pattern and correlates of pre-transplant neurocognitive dysfunction in a prospective sample of adults undergoing HCT. Neurocognition was assessed using the Montreal Cognitive Assessment Battery. Frailty was assessed using the Short Physical Performance Battery. Linear regression analysis was used to examine the associations between neurocognitive performance and frailty. Profiles of neurocognitive performance were also examined by partitioning MoCA scores into relevant domains of interest, including Executive Function and Memory. Regression analyses controlled for age, gender, education, and disease type. One hundred and ten adults were evaluated across a wide age range (range: 19-75; mean age = 54.7 [SD = 14.1]). Neurocognitive performance tended to fall below published normative levels (mean MoCA = 25.5 [SD = 4.1]), with 20% of participants demonstrating impaired performance compared with medical patients (score < 24) and 34% exhibiting impaired performance relative to healthy normative samples (score <26). Examination of cognitive profiles revealed that while mild impairments in Executive Function were common across the entire sample, greater age was most closely associated with worse Memory performance (r = -0.33, P<.01) and greater levels of short physical performance battery score were most strongly associated with worse Executive Function (r = -0.39, P<.01). Neurocognitive impairments are common among adults undergoing HCT and the pattern of performance varies by age. Frailty is a strong correlate of neurocognitive function and particularly Executive Function components. [ABSTRACT FROM AUTHOR]