Abstract
Objective
Cognitive impairment (CI) is highly prevalent in breast cancer survivors (BCS), and can be a barrier to health‐promoting behaviors. However, the ways in which CI may affect self‐regulation or motivation to perform such behaviors have not been explored. We assessed if BCS with CI report greater extrinsic self‐regulation compared to those without CI and if this relationship persists after controlling for depression.
Methods
We recruited BCS with diabetes and assessed cognition and motivation to perform healthy diabetes management behaviors (e.g., diet and exercise). Participants completed a cognitive battery evaluating attention, working memory, executive functioning (EF), processing speed (PS), language, and memory. The Treatment Self‐Regulation Questionnaire (TSRQ) assessed intrinsic vs. extrinsic motivation. Depression was determined by a score ≥16 on the Center for Epidemiological Studies Depression Scale. Wilcoxon rank‐sum test compared associations between CI and TSRQ scores.
Results
Participants were 118 older adults (mean age 65 years). Participants with CI in the following domains had higher extrinsic self‐regulation scores compared to those without CI: attention (p < 0.01), PS (p = 0.01), EF (p < 0.01), language (p = 0.02; p = 0.04), and memory (p = 0.04; p = 0.03). After adjusting for depression, the relationship between CI and higher extrinsic self‐regulation scores remained significant.
Conclusions
BCS with CI appear to rely more on external sources of motivation to perform health behaviors, regardless of depression. Future studies and interventions to improve health behaviors should consider screening for CI and involving caregivers for those with CI to improve outcomes.
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