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Cognitive Predictors of Reasoning through Treatment Decisions in Patients with Newly Diagnosed Brain Metastases

Published online by Cambridge University Press:  01 July 2015

Adam Gerstenecker ,
Kevin Duff ,
Karen Meneses ,
John B. Fiveash ,
Louis B. Nabors  and
Kristen L. Triebel
Adam Gerstenecker
Affiliation:
Department of Neurology, Division of Neuropsychology, UAB, Birmingham, Alabama
Kevin Duff
Affiliation:
Department of Neurology, University of Utah, Salt Lake City, Utah
Karen Meneses
Affiliation:
Comprehensive Cancer Center, UAB, Birmingham, Alabama School of Nursing, UAB, Birmingham, Alabama
John B. Fiveash
Affiliation:
Comprehensive Cancer Center, UAB, Birmingham, Alabama Department of Radiation Oncology, UAB, Birmingham, Alabama
Louis B. Nabors
Affiliation:
Comprehensive Cancer Center, UAB, Birmingham, Alabama Department of Neurology, Division of Neuro-oncology, UAB, Birmingham, Alabama
Kristen L. Triebel*
Affiliation:
Department of Neurology, Division of Neuropsychology, UAB, Birmingham, Alabama Comprehensive Cancer Center, UAB, Birmingham, Alabama
*
Correspondence and reprint requests to: Kristen L. Triebel, Department of Neurology, University of Alabama at Birmingham, Sparks Center 650, 1720 7th Avenue South, Birmingham, AL 35294-0017. E-mail: ktriebel@uab.edu
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Abstract

To examine the association between reasoning through medical treatment decisions and cognition in a sample of patients with brain metastasis. The association between reasoning and cognition was examined using data from 41 patients with diagnosed brain metastasis. All diagnoses were made by a board-certified radiation oncologist and were verified histologically. In total, 41 demographically matched, cognitively healthy controls were also included to aid in classifying patients with brain metastasis according to reasoning status (i.e., intact or impaired). Results indicate that measures of episodic memory and processing speed were associated with reasoning. Using these two predictors, actuarial equations were constructed that can be used to help screen for impaired reasoning ability in patients’ with brain metastasis. The equations presented in this study have clinical significance as they can be used to help identify patients at risk for possessing a diminished ability to reason through medical treatment decisions and, thus, are in need of a more comprehensive evaluation of their medical decision-making capacity. (JINS, 2015, 21, 412–418)

Keywords

Medical decision-makingCognitionMalignant brain tumorMedical ethicsMemoryVerbal fluency
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 21 , Issue 6 , July 2015 , pp. 412 - 418
Copyright
Copyright © The International Neuropsychological Society 2015 

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