Screen-detected cognitive impairment, psychological distress, and quality of life in cancer patients undergoing chemotherapy in Yemen

Cancer care in Yemen faces limited data and resources. Chemotherapy may cause cognitive, psychological, and quality-of-life complications. This study assesses the prevalence of screen-positive cognitive impairment (based on MoCA screening), anxiety, depression, and quality-of-life outcomes, as well as their associated factors, among Yemeni patients. A cross-sectional study was conducted in June–July 2025 at the National Oncology Center, Sana’a, involving adult cancer patients receiving chemotherapy. Cognitive function (MoCA), anxiety/depression (HADS), and quality of life (SF-12) were assessed via structured interviews, and data were analyzed using descriptive statistics and multiple regression (SPSS v28, p < 0.05). Among 167 patients, most were male (64.7%), married (83.8%), and in advanced cancer stages (81.3%). Only 6% had normal cognition, while 94% demonstrated screen-positive cognitive impairment, particularly in language and visuospatial domains. Borderline or abnormal anxiety and depression were observed in approximately 20% of patients. Mean PCS-12 (40.4) and MCS-12 (43.2) scores indicated reduced health-related quality of life. In multivariable regression, the cognitive model was significant and explained 41.7% of the variance (adjusted R² = 0.417). Older age (B = − 2.39), male sex (B = − 3.43), and smoking (B = − 1.42) were associated with lower cognition, whereas higher education was positively associated (B = 2.34). The PCS-12 and MCS-12 models explained 11.6% (adjusted R² = 0.046) and 10.0% (adjusted R² = 0.028) of the variance but were not significant overall. Higher education (B = 1.49) and smoking (B = − 2.44) were associated with physical health, while employment (B = 3.71) and metastasis (B = 3.41) were associated with mental health. Cognitive, psychological, and quality-of-life impairments are highly prevalent among Yemeni cancer patients receiving chemotherapy. Education, lifestyle, and clinical factors significantly influence these outcomes, underscoring the need for tailored interventions and supportive care in resource-limited settings. These findings can guide policy and clinical practice by promoting routine screening and tailored supportive care in oncology settings.