ORIGINAL PAPER Barbara Eberhardt Æ Stefan Dilger Æ Frauke Musial Ulrich Wedding Æ Thomas Weiss Wolfgang H. R. Miltner Short-term monitoring of cognitive functions before and during the first course of treatment Received: 4 July 2005 / Accepted: 6 December 2005 / Published online: 14 January 2006 Ó Springer-Verlag 2006 Abstract Purpose: Side effects of chemotherapy on cog- nitive functions in older patients have rarely been investigated. Addressing this lack of research, the pres- ent study evaluated cognitive functions in older cancer patients. Methods: A total of 130 younger (n=59; age<60) and older (n=71; age‡60) cancer patients with hematological disease or cancer of the intestinal tract took part in the study. To explore short-term effects of chemotherapy, a group of patients assessed before the start of chemotherapy was compared with patients who already received their first course of chemotherapy. Results: Cognitive impairments of verbal learning, word fluency, and memory were observed following the first few days after treatment onset. Older patients showed stronger memory impairments after start of chemo- therapy than younger cancer patients. Additionally, depression was neither associated with short-term effect of chemotherapy nor with age. Conclusions: The results suggest that chemotherapy has negative short-term effects on some cognitive functions. But age-dependent effects were only found for memory. Keywords Older cancer patients Æ Cognitive impairments Æ Chemotherapy Æ Depression Æ Gender Introduction Incidence and mortality of cancer increases significantly with age (Schonwetter 1992; Monfardini and Yancick 1993; Roche et al. 1997). Considering the growing geri- atric population in Western societies, cancer in old age will be a prominent future challenge for medical and psychological treatment. General physical conditions, co-morbidities, pharmacological as well as psychological and cognitive factors have to be considered in order to provide the optimal treatment for older cancer patients. So far, only a few studies have investigated cognitive functions following chemotherapy in adult patients, notably in breast cancer patients (Wieneke and Dienst 1995; Van Dam et al. 1998; Schagen et al. 1999; Brezden et al. 2000). These studies give evidence that adjuvant chemotherapy may result in significant cognitive impairments in patients with breast cancer. The degree of cognitive impairment was demonstrated to follow a dose function of chemotherapy. When groups exposed to a high-dose chemotherapy were compared to groups receiving a standard-dose chemotherapy, patients ex- posed to higher doses of chemotherapy showed more severe cognitive deficits than those with low doses of therapy. In addition, the decrease of cognitive functions was positively correlated with the duration of chemo- therapy but unrelated to the type of chemotherapy or to depression (Wieneke and Dienst 1995; Brezden et al. 2000). Although only little is known about the cognitive consequences of chemotherapy in old age, there is some evidence for an age-dependent detrimental effect of chemotherapy on cognitive functions. In a series of prospective clinical trials, Taylor et al. (1998) evaluated the effects of cranial radiotherapy and chemotherapy on cognitive performance in glioma patients by the use of the mini-mental-status examination (MMSE). Patients with a substantial decrease of the MMSE score were significantly older than those with no decrease of scores 6 months after treatment onset. Many studies support the notion that the aging population is confronted with an increase of physical and psychological disabilities and serious diseases. Additionally, many studies have shown that older peo- ple have less physical resistance as well as somatic and B. Eberhardt (&) Æ S. Dilger Æ F. Musial Æ T. Weiss W. H. R. Miltner Institute of Psychology, Department of Biological and Clinical Psychology, Friedrich-Schiller-University, Am Steiger 3/1, 07743 Jena, Germany E-mail: eberhard@biopsy.uni-jena.de Tel.: +49-3641-945151 Fax: +49-3641-945142 U. Wedding Department of Internal Medicine, Friedrich-Schiller-University, Erlanger Allee 101, 07747 Jena, Germany J Cancer Res Clin Oncol (2006) 132: 234–240 DOI 10.1007/s00432-005-0070-8