Paper Presentation: Research Topics — Physical Activity, the Childhood Cancer Symptom Cluster - Leukemia, and Cognitive Function: A Longitudinal Mediation Analysis (216-1)

11:30–11:50 am Friday, September 6

Children undergoing treatment for leukemia report co-occurring symptoms of fatigue, sleep disturbances, pain, nausea, and depression as a symptom cluster. Physical activity (PA) is essential for development and may influence symptom severity. Children with leukemia are at risk for cognitive impairments from CNS directed therapies. Longitudinal parallel-process (LPP) modeling is a type of analysis that examines relationships between two or more longitudinal processes. Using an LPP model, we were able to explore relationships among the functions of PA and cognition with symptom clusters over the trajectory of leukemia treatment.

This study examined the longitudinal mediation effects of PA on cognition via a symptom cluster during leukemia treatment. Symptoms, PA, and cognitive function of 327 children ages 3 to 18 were measured over 4 intervals during the first year of leukemia treatment. Children age 7 years and older self-reported, and parents reported for younger children. Parents completed child cognitive function measurements regardless of age. Using the LLP model, the influence of the first time-point and the subsequent change between all 4 time-points of PA on the symptom cluster was explored. The analysis was also performed to determine whether the symptom cluster mediates the effect of cognition over the treatment period. Patients with a higher PA at Time 1 reduced their symptom cluster severity over the 4 measurements. However, when PA increased over the measurements, symptom cluster severity also increased. When the symptom cluster was more severe at Time 1, cognitive function was lower at Time 1, and cognitive function decreased over time. When symptoms became more severe over time, cognitive function declined.

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