BACKGROUND Cognitive impairment in survivors of blood or bone marrow transplantation (BMT) is well documented. However, to the authors' knowledge, the clinical relevance of self-endorsed cognitive problems and their relation to objectively assessed cognitive impairment is not known. METHODS The authors assessed cognitive impairment in 378 BMT recipients (median age, 52.2 years, 40% of whom were female and 68% of whom were non-Hispanic white) and 98 healthy controls at 5 predetermined time points: at baseline (before BMT) and at 6 months, 1 year, 2 years, and 3 years after BMT. Self-endorsed cognitive problems were evaluated using the Neuropsychological Impairment Scale (NIS) and correlated with a standardized 2-hour battery of objective cognitive testing at each time point. The authors examined the magnitude of difference in self-endorsed cognitive problems between BMT recipients and healthy controls, and the rate of change in scores over time. Multivariable analyses were used to identify clinical and/or demographic variables associated with self-endorsed cognitive problems. The authors also examined the association between cognitive impairment and returning to work after BMT. RESULTS Compared with healthy controls, BMT recipients endorsed more cognitive problems (P < .001) at all time points, and the rate of change in NIS scores was found to be significantly greater in BMT recipients. Fatigue was associated with greater endorsement of cognitive problems at 1 year after BMT (odds ratio, 4.23; 95% CI, 2.1-8.3 [P < .001]). Overall, there was a statistically significant, modest correlation noted between self-endorsed cognitive problems and objective cognitive impairment (range, 0.401-0.445 [P ≤ .01]). Higher self-endorsed cognitive problems were associated with a 3.7-fold (P = .02) higher odds of not returning to work at 3 years after BMT. CONCLUSIONS The results of the current study demonstrated that self-endorsed cognitive problems can help to identify vulnerable patient subpopulations for detailed cognitive assessment and possible cognitive remediation.

中文翻译：

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在血液或骨髓移植接受者中，自我认可的认知问题与客观评估的认知障碍的关系：一项纵向研究。

背景技术血液或骨髓移植（BMT）的幸存者中的认知障碍已有充分的文献记载。然而，据作者所知，自我认可的认知问题的临床相关性及其与客观评估的认知障碍的关系尚不清楚。方法作者评估了378个BMT接受者（中位年龄为52.2岁，其中40％为女性，其中68％为非西班牙裔白人）和98个健康对照者在5个预定时间点的认知障碍：基线（BMT之前）在BMT之后的6个月，1年，2年和3年。使用神经心理障碍量表（NIS）对自我认可的认知问题进行评估，并将其与每个时间点的标准化2小时客观认知测试联系起来。作者研究了BMT接受者和健康对照者之间自我认可的认知问题的差异程度以及分数随时间的变化率。使用多变量分析来确定与自我认可的认知问题相关的临床和/或人口统计学变量。作者还研究了认知障碍与BMT后重返工作之间的关系。结果与健康对照组相比，BMT接受者在所有时间点都认可了更多的认知问题（P <.001），并且发现NIS得分的变化率在BMT接受者中明显更大。BMT后1年，疲劳与认知问题的更多支持相关（赔率，4.23； 95％CI，2.1-8.3 [P <.001]）。总体而言，有统计学意义 自我认可的认知问题和客观认知障碍之间存在适度的相关性（范围0.401-0.445 [P≤.01]）。较高的自我认可的认知问题与BMT后3年不返回工作的几率高3.7倍（P = .02）。结论当前研究的结果表明，自我认可的认知问题可以帮助识别易受伤害的患者亚群，以进行详细的认知评估和可能的认知矫正。