@article {WANG2021104521, title = {Longitudinal associations between cancer history and cognitive functioning among older adults}, journal = {Archives of Gerontology and Geriatrics}, volume = {97}, year = {2021}, pages = {104521}, abstract = {Objectives This study aimed to examine 1) whether cancer history accelerates older adults{\^a}{\texteuro}{\texttrademark} rates of cognitive decline over time and 2) whether chemotherapy increases older cancer patients{\^a}{\texteuro}{\texttrademark}/ survivors{\^a}{\texteuro}{\texttrademark} rates of cognitive decline over time. Methods This longitudinal study drew a subsample of 8,811 adults aged 65 or older from Wave 6 of the Health and Retirement Study in 2002 and followed biannually until Wave 13 in 2016. Linear mixed-effects models were performed to test whether cancer history and chemotherapy were associated with accelerated rates of cognitive decline over time among older adults in different age groups. Results Middle-old adults (aged 75-84) with a cancer history had significantly reduced rates of cognitive decline over time, including the global measure of cognitive functioning (B= .16, p< .01), mental status (B= .08, p< .01), and episodic memory (B= .09, p< .05) compared to their counterparts without a cancer history. This effect was not significant for the youngest-old (aged 65-74) or oldest-old adults (aged 85 or older). Also, chemotherapy was not significantly associated with older cancer patients{\^a}{\texteuro}{\texttrademark}/survivors{\^a}{\texteuro}{\texttrademark} cognitive functioning at baseline or over time in different age groups. Conclusions This study finds that cancer history and chemotherapy do not further exacerbate older adults{\^a}{\texteuro}{\texttrademark} cognitive functioning over time. On the contrary, cancer history shows a {\^a}{\texteuro}{\oe}protective{\^a}{\texteuro} effect on middle-old adults{\^a}{\texteuro}{\texttrademark} cognitive functioning. This encouraging finding indicates that older adults can be more actively engaged in the decision-making of treatments and following care plans. Future mediation studies are needed to further investigate underlying mechanisms.}, keywords = {Cancer history, Chemotherapy, cognitive functioning, Middle-old adults, Mixed-effects modeling}, issn = {0167-4943}, doi = {10.1016/j.archger.2021.104521}, author = {Kun Wang and Leah P. Cheatham and Alexander R. Marbut and Xiayu Chen} }