Alzheimer’s Disease Medication May Not Improve Cognitive Impairment in Breast Cancer Survivors

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Findings from a study conducted in women with a history of breast cancer demonstrated that treatment with donepezil, which is typically used to treat symptoms of Alzheimer’s disease and dementia, did not improve cognitive impairment, or “chemo brain.”

An Alzheimer's disease/dementia medication did not significantly improve cancer-related cognitive impairment in breast cancer survivors, according to findings from a recent study.

Findings from the REMEMBER trial were presented at the 2023 ASCO Annual Meeting.

Researchers who conducted this study analyzed data from 276 women aged 18 years and older (mean age, 57 years) with a history of breast cancer. In addition, these women underwent four or more cycles of cytotoxic chemotherapy one to five years before enrolling into this trial and had evidence of cognitive impairment with a memory deficit.

Patients were randomly assigned either donepezil (140 patients), a medication used to treat mild to moderate Alzheimer’s disease symptoms like confusion and memory loss, or placebo (136 patients).

Of note, women assigned donepezil received the original dose of 5 milligrams for six weeks. If tolerated, the daily dose was increased to two tablets, totaling 10 milligrams, for the rest of 24-week treatment period.

Women in the study reported their outcomes at the start of the study and at weeks 12, 24 and 36.

Between the start of the study and week 12, patients in both groups experienced improvements in cognitive impairment scores. This became a slight improvement at 24 weeks and a slight decrease at 36 weeks.

“The magnitude of change was comparable across treatments at all timepoints,” the researchers wrote in the abstract.

Researchers did not observe any statistically significant differences in cognitive function scores at 12, 24 and 36 weeks. This lack of difference between both groups persisted after researchers removed certain factors from the analysis such as fatigue and depression at the start of the study, education levels, menopausal status and potential treatment interaction with endocrine therapy.

Cognitive impairment — also known as “chemo brain” — relates to a decrease in the ability to remember certain things or completing tasks, according to the American Cancer Society. This can either be a short- or long-term effect of treatment, and may be a result of several factors including treatment, older age, hormone changes and emotional distress, among other causes.

Currently, there are several treatments for cognitive impairment such as cognitive rehabilitation, meditation and exercise, according to the American Cancer Society.

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