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Aerobic Exercise May Improve Neurocognition in Patients With Breast Cancer

Leigh Precopio

Postmenopausal women with breast cancer who are receiving endocrine therapy and complete moderate intensity aerobic exercise may have improved neurocognition when compared with those who do not do aerobic exercise, according to the results of a study recently presented at the Oncology Nursing Society’s 2023 Congress.

The Exercise Program in Cancer and Cognition (EPICC) clinical trial included 153 postmenopausal women who were within 2 years of receiving an early-stage, hormone receptor positive breast cancer diagnosis. All participants were randomized to complete 6 months of at least 150 minutes of moderate intensity aerobic exercise per week (n = 77) or to receive usual care (n = 76). Those in the exercise intervention were monitored by certified coaches during their exercise sessions for intensity and safety.

Multidimensional battery of objective measures was used to determine levels of neurocognitive function at pre-randomization (Time 1) and following 6 months of intervention (Time 2). Data was analyzed with and without covariates, which included age, years of education, estimated intelligence, chemotherapy use, and time on endocrine therapy.

“Aerobic exercise may be an effective, low-cost, easily adoptable intervention to mitigate neurocognitive decline in women with [breast cancer],” the researchers wrote of the study results.

Processing speed had significant group-by-time effects and marginally significant time effects. Additionally, learning and memory, working memory, attention, mental flexibility, and verbal memory had significant time effects.

Processing speed, learning and memory, and working memory improved in the exercise group, but not in the control group. Improvements were observed in both groups for attention and mental flexibility, although mental flexibility was marginally significant in the exercise group.

After controlling for Time 1 between-group differences, marginally significant group effects were observed among the exercise group for verbal memory performance at the end of intervention when compared with the control group.

Across multiple cognition factors, older age was a significant covariate. The researchers also found that increased adherence to the prescribed amount of exercise was associated with increased cognitive performance over time. Further, younger women and less educated women may achieve greater benefit from the intervention. However, a limitation of the study included a study population that was predominantly White and well-educated.

“Additional research is needed to determine the optimal exercise dose for maximal neurocognitive benefit, and to determine the mechanisms of change in neurocognitive function with exercise.”



Bender C, Gentry A, Cuglewski C, Conley Y, Erickson K, Sereika S. Improved neurocognitive function with aerobic exercise in postmenopausal women with breast cancer, results of the EPICC clinical trial. Poster presented at: ONS Congress; April 26-30, 2023; San Antonio, TX. Accessed April 19, 2023.