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Occupational Medicine Advance Access originally published online on July 1, 2009
Occupational Medicine 2009 59(6):406-412; doi:10.1093/occmed/kqp094
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© The Author 2009. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Cognitive limitations in occupationally active malignant brain tumour survivors

Lisseth Calvio1, Michael Feuerstein1,2, Jennifer Hansen1,3 and Gina M. Luff1,3

1 Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
2 Department of Psychiatry, Georgetown University Medical Center, Washington, DC, USA
3 Department of Psychology, American University, Washington, DC, USA

Background Occupationally active malignant brain tumour survivors (MBTS) are rarely studied. However, cognitive limitations with the potential to impact work are commonly reported in MBTS.

Aims To obtain a better understanding of factors that are associated with cognitive limitations in employed MBTS.

Methods The study was performed by means of a web-based survey. Occupationally active MBTS (n = 113) and a non-cancer comparison group (n = 123) were recruited. While accounting for demographics, medical factors, health behaviours and problem-solving orientation, the relationship among measures of symptom burden (fatigue, depression and anxiety) and cognitive limitations were investigated.

Results MBTS (average 4 years post-diagnosis) reported higher levels of physical fatigue (P < 0.001), depression (P < 0.001) and anxiety (P < 0.01). MBTS reported more overall cognitive limitations (P < 0.001), memory (P < 0.001), executive function (P < 0.001) and attention (P < 0.001) deficits. Education (B = –3.4, 95% CI = –6.7 to 0.1), ethnicity (B = 5.2, 95% CI = 0.6–9.8), job stress (B = 3.9, 95% CI = 1.5–6.4), depressive symptoms (B = 0.7, 95% CI = 0.1–1.3) and negative problem solving (B = 4.2, 95% CI = 1.5–7.0) were also associated with higher levels of cognitive limitations in both groups.

Conclusions Occupationally active MBTS report higher levels of cognitive limitations. However, modifiable factors were related to cognitive limitations in both groups and should be considered when developing approaches to improve cognitive limitations in the workplace.

Keywords      Attention; brain tumour; cognitive limitations; executive function; memory; occupational activity

Correspondence to: Michael Feuerstein, Department of Medical and Clinical Psychology and Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA. Tel: +1 (301) 295 9677; fax: +1 (301) 295 3034; e-mail: mfeuerstein{at}usuhs.mil


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