Cognitive Function and Quality of Life in Long-Term High-Grade Glioma Survivors

Overview

Long-term survivors of high-grade gliomas (HGG) exhibit significant cognitive impairments across multiple domains compared to normative data, despite stable global health status. Functional aspects of quality of life are substantially reduced, and cognitive deficits correlate with caregiver burden.

Background

High-grade gliomas have a poor prognosis despite aggressive treatment, with cognitive impairment arising from the tumor, treatments, and comorbidities. Cognitive function and health-related quality of life (HRQoL) are positively correlated with survival, yet data on long-term survivors remain limited. Assessing cognition accurately is essential for appropriate support, and the impact on caregivers over prolonged survival is not well understood.

Data Highlights

Key Findings

• At group level, long-term HGG survivors scored significantly lower on cognitive tests across verbal memory, attention, executive function, and language compared to healthy controls.
• Individual cognitive performance varied widely; only 5% showed no impairment, while most had mild to severe impairments on multiple subtests.
• Patients with survival ≥12 years showed significantly worse delayed verbal memory performance.
• Global health status reported by patients did not differ from normative data, but all functional quality of life scales were substantially reduced.
• No significant cognitive differences were found based on tumor hemispheric location or grade.
• Cognitive impairments were associated with increased caregiver strain and burden, highlighting the impact on caregivers over long-term survival.

Clinical Implications

Clinicians should be aware that long-term HGG survivors frequently experience significant cognitive deficits despite stable global health perceptions, necessitating routine cognitive screening and supportive interventions. Additionally, caregiver burden remains substantial and should be addressed through psychosocial support and resources. Tailored rehabilitation and monitoring may improve functional outcomes and quality of life for both patients and caregivers.

Conclusion

Long-term survivors of high-grade gliomas demonstrate persistent cognitive impairments and reduced functional quality of life, underscoring the need for comprehensive assessment and support strategies that encompass both patients and their caregivers.

References

1. Erasmus MC Rotterdam Study 2019-2020 -- Cognitive Function and Quality of Life in Long-Term High-Grade Glioma Survivors