Abstract B135: The impact of physical activity on cancer-associated cognitive decline, fatigue, and health outcomes among cancer survivors in the U.S.
Authors: Allen Jaimi Mimi L. 
Published: December 2023

Abstract
Purpose: This study aimed to examine the influence of physical activity (PA) on cancer-associated cognitive decline (CACD) and CACD risk factors (e.g., age, fatigue, depression, sleep) among cancer survivors compared to those without a history of cancer. Methods: Using data from the 2020 National Health Interview Survey, differences in key health outcomes and the mediating effects of PA were explored. Chi-square tests were used to examine group differences. Multinomial logistic regression models were fit to examine associations between PA, CACD, CACD risk factors, and other health outcomes (cognition, fatigue, anxiety, depression, health status, sleep, work limitations, and body mass index [BMI]). Results: Cancer survivors were less likely to meet sufficient levels of PA to achieve health benefits when compared to those without a history of cancer. Cancer survivors were also more likely to experience cognitive difficulties, trouble remembering, frequent fatigue, depression, poor/fair health status, more likely to experience work limitations and miss work due to health, and less likely to be employed fulltime. Overall, physical activity (PA) had a significant positive impact on all measured health outcomes even after adjusting for age, sex, race/ethnicity, income, and education. Participants without a history of cancer and who met the PA criteria were less likely to experience cognitive difficulties, frequent fatigue, frequent anxiety, depression, poor/fair health, insufficient sleep, work limitations, and unhealthy BMI (underweight, overweight, or obese categories). These relationships were often strengthened by race and sex (male) and with higher levels of income and education. Unadjusted results showed a positive significant relationship between PA and all measured health outcomes for cancer survivors. Although cancer survivors did not see the same benefits from PA with underweight BMI or anxiety when adjusting for confounders, PA served as a protective factor with all other variables. Cancer survivors who meet PA recommendations in both aerobic and strengthening activities were less likely to report some or a lot of cognitive difficulty. Cancer survivors who met PA criteria were also less likely to experience frequent fatigue, depression, poor/fair health, work limitations, overweight and obesity, and more likely to get the recommended 7-9 hours of sleep at night. Again, most of these relationships were strengthened by higher levels of income and education. Health disparities based on race/ethnicity, sex, and age were more apparent in the cancer survivor group. Conclusion: PA has shown tremendous promise towards the lingering effects of cancer and cancer treatments. More research is needed to inform exercise prescriptions (i.e., frequency, intensity, time, type), optimal timing of interventions, and for whom physical activity may be most beneficial in relation to cognitive health.
Citation Format: Jaimi Mimi L. Allen. The impact of physical activity on cancer-associated cognitive decline, fatigue, and health outcomes among cancer survivors in the U.S. [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B135.