Physical activity and cancer-related cognitive impairment: Is physical activity associated with perceived difficulties and unmet needs?

PURPOSE: Cancer-related cognitive impairment (CRCI) is associated with significant functional difficulties and unmet needs. Physical activity (PA) is a promising approach for reducing perceived CRCI; however, its relationship with perceived CRCI-related difficulties and unmet needs remains unclear. This study examined the associations between PA, perceived cognitive functioning, and perceived CRCI-related difficulties and unmet needs, and assessed whether PA explained additional variance in perceived CRCI-related difficulties and unmet needs after controlling for perceived cognitive functioning. METHODS: In this cross-sectional study, adult cancer survivors receiving curative-intent treatment (n = 418) who self-identified as experiencing CRCI completed the PROMIS-Cog, MASCC COG-IMPACT, and modified Godin-Shephard Leisure-Time Physical Activity Questionnaire. Bivariate correlation analyses and hierarchical multiple regression analyses were conducted to examine associations between physical activity, perceived cognitive functioning, and CRCI-related difficulties and unmet needs, and to determine whether physical activity explained additional variance in CRCI-related difficulties and unmet needs beyond perceived cognitive functioning. RESULTS: Greater engagement in light-, vigorous-, and resistance-based PA was associated with better perceived cognitive functioning (r = 0.10-0.14; p < 0.05) with small effects. PA was also associated with fewer psychological (r =- 0.11; p < 0.05) and verbal communication (r =- 0.13; p < 0.05) CRCI-related difficulties, but more CRCI-related informational need difficulties (r = 0.13-0.17; p < 0.01) with small effects. PA was not associated with CRCI-related unmet needs (p > 0.05). After controlling for perceived cognitive functioning, greater PA was associated with greater perceived CRCI-related difficulties and unmet needs in several domains (p < 0.05). CONCLUSIONS: Physical activity was associated with reduced perceived CRCI severity, supporting its recognition as a promising supportive care strategy. However, associations between greater physical activity participation and lower levels of perceived CRCI may not correspond with lower levels of CRCI-related difficulties and unmet needs. PA-based CRCI interventions should be embedded within holistic survivorship care models that proactively identify and address perceived CRCI-related difficulties and unmet supportive care needs.