Cognition and health-related quality of life in long-term survivors of high-grade glioma: an interactive perspective from patient and caregiver - Scorecard - MDSpire
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Cognition and health-related quality of life in long-term survivors of high-grade glioma: an interactive perspective from patient and caregiver
Clinical Scorecard: Cognitive Function and Quality of Life in Long-Term High-Grade Glioma Survivors: Insights from Patients and Caregivers
At a Glance
Category
Detail
Condition
High-grade gliomas (WHO grade III and IV)
Key Mechanisms
Tumor effects, treatment-related brain impairment, co-morbidities (e.g., epilepsy), and medication impact cognitive function
Target Population
Adult long-term survivors (≥5 years) of high-grade glioma and their caregivers
Care Setting
Neuro-oncology outpatient and rehabilitation settings
Key Highlights
Long-term HGG survivors show significant cognitive impairments in verbal memory, attention, executive function, and language compared to normative data.
Cognitive impairments increase with longer survival (≥12 years) particularly in verbal memory.
Caregivers experience prolonged psychological distress and burden related to patient cognitive status.
Guideline-Based Recommendations
Diagnosis
Use validated cognitive tests (e.g., HVLT, TMT, BNT) and questionnaires to assess multiple cognitive domains.
Include both patient and caregiver reports to capture perceived cognitive functioning and quality of life.
Exclude patients unable to perform tests or with language barriers to ensure accurate assessment.
Management
Refer patients with identified cognitive impairments for appropriate support or rehabilitation.
Address psychological distress and burden in caregivers through supportive interventions.
Consider long-term monitoring of cognitive function as impairments may worsen over time.
Monitoring & Follow-up
Perform regular cognitive assessments using standardized tests and questionnaires.
Monitor health-related quality of life (HRQoL) and psychological well-being in both patients and caregivers.
Use z-scores to quantify severity of cognitive impairments and guide clinical decisions.
Risks
Cognitive decline can negatively impact survival and quality of life.
Discrepancies may exist between objective cognitive test results and perceived cognition by patients and caregivers.
Caregiver strain and burden may persist for years, affecting caregiver mental health.
Patient & Prescribing Data
Long-term survivors of WHO grade III and IV gliomas treated with surgery, radiotherapy, and chemotherapy
Maximal safe resection and combined modality treatment are standard; cognitive impairments persist despite treatment and stable disease.
Clinical Best Practices
Incorporate multi-domain cognitive testing and HRQoL questionnaires in long-term follow-up of HGG survivors.
Engage caregivers in assessments to better understand patient functioning and caregiver burden.
Use normative data and standardized scoring to identify mild and severe cognitive impairments.
Tailor rehabilitation and supportive care based on individual cognitive profiles and caregiver needs.
by Jochem K. H. Spoor, Marike Donders-Kamphuis, Wencke S. Veenstra, Sarah A. van Dijk, Clemens M. F. Dirven, Peter A. E. Sillevis Smitt, Martin J. van den Bent, Sieger Leenstra, Djaina D. Satoer
