Tomatoes, Lycopene, and Prostate Cancer: What Have We Learned from Experimental Models?

Human epidemiology suggests a protective effect of tomatoes or tomato phytochemicals, such as lycopene, on prostate cancer risk. However, human epidemiology alone cannot reveal causal relations. Laboratory animal models of prostate cancer provide opportunities to investigate hypotheses regarding dietary components in precisely controlled, experimental systems, contributing to our understanding of diet and cancer risk relations. We review the published studies evaluating the impact of tomatoes and/or lycopene in preclinical models of prostate carcinogenesis and tumorigenesis. The feeding of tomatoes or tomato components demonstrates anti-prostate cancer activity in both transplantable xenograft models of tumorigenesis and models of chemically- and genetically-driven carcinogenesis. Feeding pure lycopene shows anticancer activity in most studies, although outcomes vary by model system, suggesting that the impact of pure lycopene can depend on dose, duration, and specific carcinogenic processes represented in different models. Nonetheless, studies with the transgenic adenocarcinoma of the mouse prostate (TRAMP) model of carcinogenesis typically demonstrate similar bioactivity to that of tomato feeding. In general, interventions that commence earlier in carcinogenesis and are sustained tend to be more efficacious. Accumulated data suggest that lycopene is one, but perhaps not the only, anticancer bioactive compound in tomatoes. Although it is clear that tomatoes and lycopene have anti-prostate cancer activity in rodent models, major knowledge gaps remain in understanding dose-response relations and molecular mechanisms of action. Published and future findings from rodent studies can provide guidance for translational scientists to design and execute informative human clinical trials of prostate cancer prevention or in support of therapy.

Egg protein supplementation improved upper body muscle strength and protein intake in community-dwelling older adult females who attended congregate meal sites or adult learning centers: A pilot randomized controlled trial.

Background: Older adults that utilize community-based nutrition services are at higher nutritional risk than the general aging population, yet studies on the efficacy of protein interventions in this population are lacking. Aim: A double-blinded randomized controlled pilot study trial evaluated the impact of egg white protein supplementation on muscle mass, strength, and physical function in predominantly low-income Latina community-dwelling adult females aged 60 or older with reduced muscle strength or function. Methods: Participants (mean age = 73.6 ± 8.3 years) were randomly assigned to receive a daily dried egg white (20 g protein) or isocaloric maltodextrin supplement for 6 months (n = 16 intervention; n = 13 control). The primary outcome measure was appendicular skeletal muscle mass. Secondary outcomes were measures of muscle strength and function and dietary protein intake. Comparisons of baseline demographics were conducted using t-tests and χ2 or Fisher's exact tests. Differences between groups were assessed using general linear models, adjusted for baseline values, and differences within groups were assessed using paired t-tests or Kruskal-Wallis. Results: No significant between-group differences were found for all measures, but protein intake, handgrip strength, and the number of arm curls significantly improved in the intervention group. Under-recruitment of study participants and a high dropout rate impacted the ability of this study to detect significant differences between groups. Conclusion: Daily egg white protein supplementation increases protein intake and supports upper body physical function in older adults, but additional studies are needed to investigate its role in the prevention of age-related muscle mass decline in older adults. Trial #NCT03530774 (https://clinicaltrials.gov/ct2/show/NCT03530774).

Dietary quality modifies the association between multimorbidity and change in mobility limitations among older Americans.

To identify potentially modifiable risk-factors in the age-related disablement process, we examined the association between change in mobility limitations and multimorbidity and how dietary quality moderates this association. Information from 3320 adults aged 65 and older in 2012 was drawn from the Health and Retirement Study and the Health Care and Nutrition Study. Mobility limitations reported in 2012 and change in mobility limitations from 2012 to 2014 were regressed on multimorbidity measured as number of chronic conditions in 2012, dietary quality measured in 2013 using the Alternative Healthy Eating Index-2010 (AHEI-2010), and their interaction term using Poisson regression. Respondents reported an average of 2.9 (SD, 2.9) mobility limitations in 2012 and 3.1 (SD, 3.0) mobility limitations in 2014, an average of 2.64 (SD, 1.4) chronic conditions in 2012, and mean AHEI-2010 score in 2013 of 57.1 (SD, 10.9). Greater AHEI-2010 scores were associated with fewer mobility limitations at baseline (p < .001) and slower progression of mobility limitations over the two-year observational window (p < .001). For those with AHEI-2010 scores ≥48.4, dietary quality appeared to moderate the association between multimorbidity and change in mobility limitations. These results suggest that improving dietary quality may be an effective means of reducing the progression of mobility limitations among older adults and that dietary quality may modify the effect of multimorbidity on progressive disablement. Our work adds to research supporting dietary quality as a potentially intervenable factor in the reduction of disablement in aging populations.

Investigating walnut consumption and cognitive trajectories in a representative sample of older US adults.

OBJECTIVE: Existing research suggests walnut intake may be associated with better cognitive function in older adults, yet few studies utilise longitudinal data from observational studies of ageing populations. Our objective was to estimate the association between whole walnut intake and cognitive change in a representative sample of older Americans. DESIGN: Secondary analysis of the Health and Retirement Study and Health Care and Nutrition Study. Walnut consumption was defined as a categorical measure (none, low intake (0·01-0·08 1 oz. servings per day) and moderate intake (>0·08 1 oz. servings per day)) and cognitive function was measured using the Telephone Interview for Cognitive Status. Latent growth modelling estimated the association between walnut consumption and trajectories of cognitive status over a 4-year observational period. Sensitivity analyses assessing non-random dropout and Monte Carlo power analyses were conducted to contextualise results. SETTING: The USA. PARTICIPANTS: A sample of 3632 US adults aged 65 years and older. RESULTS: Those reporting any walnut consumption had greater cognitive scores at baseline than those not consuming walnuts (low walnut consumption, b = 1·53, se = 0·21, P < 0·001; moderate walnut consumption, b = 2·22, se = 0·27, P < 0·001), but walnut consumption was not associated with cognitive change. Walnut consumption was positively associated with socioeconomic status and health behaviours as well as intake of nutrients identified to have neuroprotective benefits. CONCLUSIONS: We identified an association between walnut consumption and cognitive function in older adults, although we did not find that walnut consumption was protective against age-related cognitive decline.

Dietary lutein and zeaxanthin are associated with working memory in an older population.

OBJECTIVE: The purpose of the study was to examine the association between dietary lutein and zeaxanthin (L + Z) intake and immediate word recall (IWR) and delayed word recall (DWR), and to identify the major contributors to dietary L + Z intake in a recent and representative sample of the older US population. DESIGN: In this cross-sectional analysis, multivariate path analytic models estimated the association between L + Z consumption and cognitive performance while adjusting for covariates. SETTING: Observations were drawn from the 2014 Health and Retirement Study, a nationally representative panel study of older US adults, and the 2013 Health Care and Nutrition Study, which assessed dietary intake via FFQ in a subsample of respondents. PARTICIPANTS: The analytic sample included 6390 respondents aged ≥50 years. RESULTS: L + Z intake was 2·44 ± 2·32 mg/d on average, and L + Z intake differed significantly across quartiles (P < 0·001). For example, average L + Z intake in Q1 was 0·74 ± 0·23 mg/d and in Q4 was 5·46 ± 2·88 mg/d. In covariate adjusted models, older adults in the highest quartiles of L + Z intake had significantly greater IWR and DWR scores than those in the lowest quartile. Leafy vegetables, cruciferous vegetables, dark yellow vegetables, fish and seafood, legumes, eggs and fruit were significant and meaningful predictors of dietary L + Z intake. CONCLUSION: A high consumption of vegetables, fish and seafood, legumes, eggs and fruit is associated with a higher intake of L + Z and greater word recall among older adults.

Latent profile analysis of dietary intake in a community-dwelling sample of older Americans.

OBJECTIVE: To estimate latent dietary profiles in a community-dwelling sample of older Americans and identify associations between dietary profile membership and individual demographic, socio-economic and health characteristics. DESIGN: Secondary analysis of the 2012 Health and Retirement Study (HRS) and linked 2013 Health Care and Nutrition Study (HCNS). Latent profile analysis identified mutually exclusive subgroups of dietary intake and bivariate analyses examined associations between dietary profile membership, participant characteristics and nutrient intakes. SETTING: USA. PARTICIPANTS: An analytic sample of 3558 adults aged 65 years or older. RESULTS: Four dietary profiles were identified with 15·5 % of the sample having a 'Healthy' diet, 42·0 % consuming a 'Western' diet, 29·7 % having a diet consisting of high intake of all food groups and 12·7 % reporting relatively low intake of all food groups. Members of the 'Healthy' profile reported the greatest socio-economic resources and health, and members of the 'Low Intake' profile had the fewest resources and worst health outcomes. Macronutrient and micronutrient intakes varied across profile although inadequate and excessive intakes of selected nutrients were observed for all profiles. CONCLUSIONS: We identified dietary patterns among older Americans typified by either selective intake of foods or overall quantity of foods consumed, with those described as 'Low Intake' reporting the fewest socio-economic resources, greatest risk of food insecurity and the worst health outcomes. Limitations including the presence of measurement error in dietary questionnaires are discussed. The causes and consequences of limited dietary intake among older Americans require further study and can be facilitated by the HRS and HCNS.

Dietary intervention among breast cancer survivors increased adherence to a Mediterranean-style, anti-inflammatory dietary pattern: the Rx for Better Breast Health Randomized Controlled Trial.

PURPOSE: The goal of this education and culinary-based dietary intervention was to increase adherence to a Mediterranean-style, anti-inflammatory dietary pattern in breast cancer survivors (BCS) by promoting the consumption of anti-inflammatory foods, herbs, and spices. METHODS: Overweight and obese, early-stage, BCS were randomized to the Intervention (n = 76) or Control (n = 77). The 6-month intervention included monthly nutrition and cooking workshops, Motivational Interviewing telephone calls, and individualized newsletters. Control participants received monthly informational brochures and no navigational services. Dietary intakes were collected via questionnaire and 3-day food records at baseline and 6 months. RESULTS: One hundred twenty-five BCS (n = 60 I; n = 65 C) completed post-testing (81.7%) and were included in analyses. Adherence to Mediterranean diet guidelines significantly increased in the intervention group, but not in the control group (+ 22.5% vs. + 2.7%, P < 0.001). Upon further analysis of adherence to individual dietary guidelines, the intervention group significantly improved adherence to only three guidelines: consuming ≥ 3 servings of fish or shellfish/week, reducing red meat intake to < 1 serving/day, and limiting consumption of commercial sweets and baked goods to < 3 times/week. The intervention arm increased the use of spices and herbs compared to control (+ 146.2% vs. +33.3%, P < 0.001), including significantly more frequent consumption of cinnamon, turmeric, garlic, ginger, black pepper, and rosemary. CONCLUSION: An education and culinary-based intervention in BCS successfully increased adherence to a more Mediterranean-style, anti-inflammatory dietary pattern by increasing the consumption of anti-inflammatory foods, spices, and herbs and decreasing the consumption of pro-inflammatory foods.

Egg Consumption, Multi-Domain Cognitive Performance, and Short-Term Cognitive Change in a Representative Sample of Older U.S. Adults.

Objective: Existing research supports a positive relationship between egg intake and cognitive function in older populations, although the impact of whole egg consumption on multi-domain cognitive function and cognitive decline in representative samples of older adults has not been described. We examined the association between egg consumption, cognitive performance, and cognitive change in a representative sample of U.S. adults aged 65 and older. Methods: We drew observations from the 2012 and 2014 Health and Retirement Study and the recently released 2013 Health Care and Nutrition Study. The analytic sample contained 3835 respondents, representing a weighted population of 37,806,082 community-dwelling adults aged 65 and older in 2013. Multivariate path analytic models were used to estimate the association between egg consumption groups (none, ≤ 1 serving per week, 2-6 servings per week, ≥ 7 servings per week) and cognitive performance across domains of working memory, executive function, and global mental status. First-order autoregressive models were used to estimate cognitive change over the 2-year observational period. Follow-up analyses examined associations between egg consumption group, dietary patterns, and nutrient intake. Results: On average, older adults consumed 0.34 eggs per day (SD = 0.36). Although bivariate analyses suggested that moderate egg consumers had the best cognitive performance at baseline assessment, egg consumption was not associated with cognitive performance or cognitive change when adjusting models for covariates known to have a robust association with cognitive health. Conclusions: Our results suggest that egg consumption does not benefit, nor is detrimental to, the cognitive health of older adults. Further studies of whole egg consumption and cognitive performance would benefit from controlled experimental settings, longer follow-up periods to measure cognitive change, and assessment of both community-dwelling and institutionalized older adults.

Acute aerobic exercise improves memory across intensity and fitness levels.

The present study was designed to examine the impact of exercise intensity and aerobic fitness on free recall, judgments of learning (JOLs), and metacognitive accuracy. In Experiment 1, 30 college students engaged in either (1) no exercise, (2) light exercise (55% of predicted maximal heart rate), or (3) moderate exercise (75% of predicted maximal heart rate) on three different days. In Experiment 2, 29 high-fit students (VO2 max ≥ 70th percentile) and 28 low-fit students (VO2 max ≤ 50th percentile) completed sedentary and light exercise conditions. In both experiments, free recall scores significantly increased in the exercise conditions compared with the sedentary condition, but JOL magnitude and metacognitive accuracy were largely unaffected. These results demonstrate that exercise can improve recall at both light and high intensities, and that the benefit can be obtained by individuals regardless of their fitness level.

Influence of Dietary Acid Load on Exercise Performance.

Diet composition can affect systemic pH and acid-base regulation, which may in turn influence exercise performance. An acidic environment in the muscle impairs performance and contributes to fatigue; therefore, current trends in sports nutrition place importance on maximizing the alkalinity of the body with ergogenic aids and dietary strategies. This review examines the evidence on the effects of dietary manipulations on acid load and exercise performance. Ten studies that investigated the effect of high versus low dietary acid loads on athletic performance generally identified that low dietary acid loads increased plasma pH, but did not consistently improve exercise performance at maximal or submaximal exercise intensities. In addition, the few studies conducted have several limitations including lack of female subjects and use of exercise tests exclusive to cycling or treadmill running. Although the research does not strongly support a performance benefit from low dietary acid loads, a more alkaline dietary pattern may be beneficial for overall health, as dietary induced acidosis has been associated with greater risk of cardiovascular disease and bone disease. The review includes dietary recommendations for athletes to reduce dietary acid load while still meeting sports nutrition recommendations.

Need for and Interest in a Sports Nutrition Mobile Device Application Among Division I Collegiate Athletes.

The majority of National Collegiate Athletic Association (NCAA) programs do not have a sports nutritionist, leaving athletes to gather information from resources that vary in reputability. The objective of this study was to identify a need for the development of accessible and reputable resources of nutrition information by assessing the current use of nutrition information resources, dietary habits, and sports nutrition knowledge among Division I collegiate athletes. Seventy-two athletes across eight sports completed questionnaires concerning nutrition resources used, dietary habits, and sports nutrition knowledge. In addition, interest levels in a mobile device application for delivery of nutrition information and tools were assessed. Primary sources for nutrition information included parents and family, athletic trainers (AT), and the internet/media, and athletes felt most comfortable discussing nutrition with parents and family, ATs, and strength and conditioning specialists. Performance on a sports nutrition knowledge questionnaire indicated a general lack of nutrition knowledge, and the high frequency of "unsure" responses suggested a lack of confidence in nutrition knowledge. Athletes conveyed a high likelihood that they would use a mobile device application as a nutrition resource, but were more interested in access to nutrition topics than tools such as a food log. We found that college athletes possess minimal sports nutrition knowledge, obtain nutrition information from nonprofessional resources, and were interested in utilizing a mobile device application as a resource. Further research is needed to explore the feasibility and effectiveness of alternative resources, such as a mobile device application, to deliver nutrition information and improve nutrition knowledge.

Relationship between fruit and vegetable intake and interference control in breast cancer survivors.

PURPOSE: Nutrition plays an important role in brain structure and function, and the effects of diet may even be greater in those at greater risk of cognitive decline, such as individuals with cancer-related cognitive impairment. However, the relation of dietary components to cognitive function in cancer survivors is unknown. The objective of this study was to determine whether breast cancer survivors (BCS) evidenced impairments in interference control, a component of cognitive control, compared to age-matched women with no prior history of cancer, and to examine the moderating role of diet on cognitive function. METHODS: In this cross-sectional study, a modified flanker task was used to assess interference control in BCS (n = 31) and age-matched women with no prior history of cancer (n = 30). Diet was assessed with 3-day food records. Differences between BCS and age-matched controls were assessed using linear mixed models, and multilevel regression analyses were conducted to assess the moderating role of diet on cognitive performance. RESULTS: Cognitive performance was not different between groups. Fruit intake and vegetable intake were significantly associated with better performance on the incompatible condition of the flanker task (i.e., shorter reaction time and increased accuracy), independent of disease status. The association between dietary components and cognition was stronger for the incompatible incongruent condition, suggesting that fruit and vegetables may be important for the up-regulation of cognitive control when faced with higher cognitive demands. CONCLUSIONS: There was no difference in performance on an interference control task between BCS and age-matched controls. The data suggest that greater fruit intake and vegetable intake were positively associated with interference control in both BCS and age-matched controls.

Subjective memory impairment and well-being in community-dwelling older adults.

BACKGROUND: The relationship between subjective memory impairment (SMI), future cognitive decline, and negative health status provides an opportunity for interventions to reduce memory complaints in high-risk groups. This study aimed to examine the relationship between SMI and indicators of well-being in older adults enrolled in an exercise trial. Additionally, the study examined whether two different modes of exercise training, aerobic walking and non-aerobic flexibility, toning, and balance, differentially influenced subjective memory across the trial. METHODS: Community-dwelling older adults (n = 179, mean age = 66.4 years) were randomly assigned to a walking or flexibility, toning, and balance group for 12 months. Subjective memory, happiness, perceived stress, and symptom reporting were measured at baseline, 6 months, and 12 months. RESULTS: A main effect of subjective memory indicated that individuals with the fewest memory complaints had lower perceived stress (P < 0.001), lower physical symptom reporting (P < 0.001), and higher happiness levels (P < 0.001) across all measurement occasions. Both main and interaction effects of time and group on SMI were not significant, suggesting SMI remained stable across the intervention and was not significantly impacted by participation in exercise training. CONCLUSIONS: SMI was not responsive to exercise interventions, and the relationship between SMI and negative well-being demonstrates a need for interventions to reduce memory complaints in high-risk groups.

Differential exercise effects on quality of life and health-related quality of life in older adults: a randomized controlled trial.

PURPOSE: Maintaining quality of life (QOL) and physical and mental health status are important outcomes throughout the aging process. Although cross-sectional studies suggest a relationship between global QOL and physical activity, it is unclear whether such a relationship exists as a function of exercise training. METHODS: We examined the effects of two exercise intervention arms on health-related quality of life (HRQOL) and global QOL. Low-active, older adults (n = 179) were randomly assigned to either a 12-month aerobic walking group or a strengthening and flexibility group. HRQOL and QOL were measured at baseline, 6, and 12 months. RESULTS: There was a significant group by time effect on QOL [F(2,176) = 3.11, p = 0.047, η (2) = 0.03]. There was also a significant overall group by time effect for HRQOL [F(4,174) = 2.46, p = 0.047, η (2) = 0.05], which was explained by the significant group by time interaction for mental health status (p = 0.041, η (2) = 0.02) favoring the walking condition. Further analyses using latent class analysis revealed three classes of individuals with differential patterns of change in QOL and HRQOL across time. These classes reflected no change, declines, and improvements in these constructs across time. CONCLUSIONS: Walking appears to enhance the mental aspect of HRQOL and global QOL when compared to a non-aerobic intervention. Additionally, the patterns of change in QOL and HRQOL were not linear over time. Our findings are in contrast to previous reports that these outcomes change a little or not at all in randomized trials.

Physical activity levels and patterns in older adults: the influence of a DVD-based exercise program.

The use of multimedia to influence health behaviors offers unique advantages over more traditional center-based programs, however, little is known about the effectiveness of such approaches in improving physical activity levels over time. The purpose of this study was to examine the efficacy of a progressive and age-appropriate, DVD-delivered exercise program in promoting physical activity levels among older adult cohorts. Community dwelling older adults (N = 307, Mean age = 71 years) were randomized to one of two groups: a 6-month home-based DVD-delivered exercise (i.e., FlexToBa™) intervention group or a healthy aging DVD control group. Physical activity was assessed objectively using a standard 7-day accelerometer wear period and subjectively using the Godin Leisure Time Exercise Questionnaire, at baseline and follow-up. Analysis of covariances indicated a statistically significant treatment effect for subjectively [F(1,250) = 8.42, P = .004, η(2) = .03] and objectively [F(1,240) = 3.77, P = .05, η(2) = .02] measured physical activity. The older cohort (>70) in the FlexToBa condition further had significantly larger improvements in physical activity levels compared to their younger counterparts. From a public health perspective, media-delivered interventions such as the FlexToBa program might prove to be cost-effective, have a broader reach and at the same time be effective in improving physical activity levels in older adults.

Lycopene and apo-12'-lycopenal reduce cell proliferation and alter cell cycle progression in human prostate cancer cells.

Lycopene is associated with a reduced risk of prostate cancer. However, lycopene may not be wholly responsible for the effects seen in vivo or in cell culture systems. Apo-lycopenals or other lycopene metabolites, whether produced by cleavage enzymes within the body or consumed with tomato products, can be found in tissues at concentrations equivalent to physiological retinoid concentrations. Therefore, it is plausible that lycopenoids, like retinoids, are bioactive within tissues. Androgen-independent DU145 prostate cancer cells were treated with lycopene, apo-8'-lycopenal, or apo-12'-lycopenal. DU145 cell proliferation was significantly reduced by supra-physiological levels of lycopene and apo-12'-lycopenal, in part, through alteration of the normal cell cycle. Levels of the gap junction protein, connexin 43, were unaltered by lycopene or apo-lycopenal treatment while cell apoptosis rates significantly decreased. We further confirmed that connexin 43 protein levels were unaltered by lycopene treatment in mouse embryonic fibroblasts, or in Dunning R3327-H rat prostate tumor. The present data indicate that lycopene and apo-12'-lycopenal reduce the proliferation of prostate cancer cells, in part, by inhibiting normal cell cycle progression.

Low Serum Carotenoids Are Associated with Self-Reported Cognitive Dysfunction and Inflammatory Markers in Breast Cancer Survivors.

Background: Dietary carotenoids may exert anti-inflammatory activities to reduce inflammation-driven cognitive impairments during cancer and cancer treatment. Our objective was to explore if cognitive function in breast cancer survivors (BCS) differs by serum carotenoid concentrations, and if blood carotenoids concentrations are associated with reduced systemic inflammation. Methods: Objective cognitive function and perceived cognitive impairment of 29 BCS and 38 controls were assessed cross-sectionally with the National Institutes of Health Toolbox Cognition Battery and The Functional Assessment of Cancer Therapy-Cognitive Function Questionnaire, respectively. Serum carotenoid and inflammatory marker (sTNF-RII, IL-6, IL-1ra, CRP) concentrations were measured. Results: Low-carotenoid BCS had more cognitive complaints compared to the low-carotenoid controls (Mdiff = -43.0, p < 0.001) and high-carotenoid controls (Mdiff = -44.5, p < 0.001). However, the cognitive complaints of high-carotenoid BCS were intermediate to and not different than the low-carotenoid BCS, or low- or high-carotenoid controls. BCS performed similarly to controls on all objective cognitive measures. Multiple linear regression, controlling for age and body mass index (BMI), demonstrated an inverse association between serum carotenoid concentrations and pro-inflammatory sTNFR-II (ß = 0.404, p = 0.005) and IL-6 concentrations (ß = -0.35, p = 0.001), but not IL-1ra or CRP. Conclusions: Higher serum carotenoid concentrations may convey cognitive and anti-inflammatory benefits in BCS. Future research should identify dietary components and patterns that support cognitive health in cancer survivors.

Recent cancer treatment and memory decline in older adults: An analysis of the 2002-2012 Health and Retirement Study.

OBJECTIVE: Few studies have examined the impact of cancer treatment on cognitive trajectories in the growing population of older adults diagnosed with and surviving cancer. This study examined whether recent cancer and its treatment accelerated memory decline in older adults. MATERIALS AND METHODS: We conducted a secondary analysis of observations drawn from the Health and Retirement Study (2002-2012), a population-based sample of older adults in the United States. Changes in immediate (IWR) and delayed word recall (DWR) scores were estimated by latent growth modeling in individuals who never had cancer (n=10,939) or had been diagnosed with cancer between 2000 and 2002 and received treatment with some combination of radiation and/or surgery (n=240), chemotherapy only (n=34), or chemotherapy and some combination of radiation and/or surgery (n=64). RESULTS: In the period immediately following treatment, individuals reporting a recent cancer treated with chemotherapy and surgery/radiation experienced significantly more rapid decline in IWR (b =-0.34, SE =0.17, p=0.047) and DWR (b=-0.38, SE=0.19, p=0.049) than the non-cancer group. Sensitivity analyses addressing mortality selection and memory-related disease at baseline attenuated the strength of these associations. There were no other statistically significant differences in estimated linear or quadratic slope by cancer status or treatment. CONCLUSION: Our results support a potential association between recent cancer treatment and trajectories of memory decline in older adults and provide guidance on the interpretation of statistical estimates from panel studies of health and aging.

Associations Between Physical Fitness Indices and Working Memory in Breast Cancer Survivors and Age-Matched Controls.

BACKGROUND: This study examined the effects of cardiorespiratory fitness, heart rate recovery, and physical activity on working memory in breast cancer survivors and age-matched controls. METHOD: Using a case-control design, 32 women who had received a breast cancer diagnosis and completed primary treatment within the past 36-months (11 radiation only; 21 chemotherapy) and 30 age-matched women with no previous cancer diagnosis completed a n-back continuous performance task commonly used as an assessment of working memory. In addition, cardiorespiratory fitness and heart rate recovery were measured during a submaximal graded exercise test and physical activity was measured using 7-days of accelerometer monitoring. RESULTS: Breast cancer survivors who had received chemotherapy had poorer heart rate recovery (p = .010) and engaged in less physical activity than women who had received radiation only (p = .004) or non-cancer controls (p = .029). Cancer treatment (radiation; chemotherapy) predicted differences in reaction times on the 1-back working memory task (p = .029). However, more rapid heart rate recovery predicted shorter reaction times on the 1-back task in the age-matched control group (p = .002). All participants with greater cardiorespiratory fitness displayed greater accuracy independent of disease status on the 1-back task (p = .017). No significant group differences in reaction times were observed for 2-back target trials between breast cancer survivors and controls. However, greater total physical activity predicted shorter reaction times in breast cancer survivors (radiation, chemotherapy) on the 2-back task (p = .014). In addition, all participants who exhibited more rapid heart rate recovery demonstrated better greater accuracy regardless of disease status (p = .013). CONCLUSION: These findings support differences in physical activty participation, heart rate recovery, and 1- and 2-back working memory reaction times between breast cancer survivors and age-matched controls. Greater cardiorespiratory fitness, heart rate recovery, and physical activity were positively associated with better working memory performance across conditions.

Moderate Physical Activity Mediates the Association between White Matter Lesion Volume and Memory Recall in Breast Cancer Survivors.

Increased survival rates among breast cancer patients have drawn significant attention to consequences of both the presence of cancer, and the subsequent treatment-related impact on the brain. The incidence of breast cancer and the effects of treatment often result in alterations in the microstructure of white matter and impaired cognitive functioning. However, physical activity is proving to be a successful modifiable lifestyle factor in many studies that could prove beneficial to breast cancer survivors. This study investigates the link between white matter lesion volume, moderate physical activity, and cognition in breast cancer survivors following treatment compared to non-cancer age-matched controls. Results revealed that brain structure significantly predicted cognitive function via mediation of physical activity in breast cancer survivors. Overall, the study provided preliminary evidence suggesting moderate physical activity may help reduce the treatment related risks associated with breast cancer, including changes to WM integrity and cognitive impairment.