QOL-20. Subjective cognition and its predictors: Exploring distress and routine in brain cancer

Abstract BACKGROUND A brain tumor (BT) diagnosis can lead to psychological distress, subjective cognitive decline, and disruption of daily routines due to symptoms, treatment, and changes in role functioning (e.g., job loss, driving limitations). While distress is a well-established correlate of subjective cognitive complaints in this population, the role of routine disruption remains understudied. This study examines whether changes in daily routine predict subjective cognition above and beyond distress. METHOD A cross-sectional survey of 137 BT patients assessed subjective cognitive functioning (FACT-Br-CI), psychological distress, and daily routine regularity. Participants rated the degree to which they experienced distress from common BT-related symptoms (e.g., mood changes, fatigue, fine motor impairments, balance difficulties, relationship changes, and physical symptoms) on a 5-point scale. Perceived regularity of daily routines was rated separately for pre- and post-diagnosis on a 4-point scale. RESULTS A paired-samples t-test revealed a significant decline in routine regularity following diagnosis, t(133) = 6.44, p <.001, d = 0.56. A difference score (post-diagnosis minus pre-diagnosis) was calculated to represent change in routine, with negative values reflecting increased irregularity and positive values reflecting greater regularity. In a hierarchical regression predicting subjective cognition, distress was a significant predictor in the initial model (β = -0.36, p <.001, R² =.13). Adding routine change significantly improved the model (ΔR² =.031, F change = 4.31, p =.040), with the final model explaining 16% of the variance (F(2, 117) = 11.38, p <.001, R² =.16). Greater routine irregularity was associated with poorer subjective cognition (β = 0.18, p =.040), independent of distress levels. CONCLUSION Routine regularity may play a meaningful role in subjective cognitive outcomes among BT patients. Future research should explore these relationships longitudinally and examine interventions that promote daily structure.