• Domain-Specific Neurocognitive Functioning measuring attention, executive functioning, mental processing speed, verbal memory, language, and visuospatial construction at baseline and 3 months after completion of treatment
  
• Global neurocognitive functioning as measured by the Mini-Mental State Examination (MMSE) at baseline, at each scheduled treatment visit, and at 3 months after completion of treatment
  
• Self-reported neurocognitive symptoms as measured by the Alertness Behavior Subscale of the Sickness Impact Profile at baseline, at each scheduled treatment visit, and at 3 months after completion of treatment
  
• Delirium and delirium symptoms by the NEECHAM Confusion Scale and Confusion Assessment Method (CAM) at baseline, at each scheduled treatment visit, and at 3 months after completion of treatment
  

• Alcohol, tobacco, and drug use as measured by the Alcohol Use Disorders Identification Test (AUDIT) at baseline
  
• Premorbid intellectual functioning as measured by the North American Adult Reading Test (NAART) at baseline
  
• Functional status measured by the Duke Older Americans Resources and Services (OARS) Activities of Daily Living Scale at baseline, at each scheduled treatment visit, and at 3 months after completion of treatment
  
• Symptom prevalence and distress measured using the short form of the Memorial Symptom Assessment Scale (MSASSF) at baseline, at each scheduled treatment visit, and at 3 months after completion of treatment
  
• Mood State measured by the Profile of Mood States (POMS-SF) at baseline, at each scheduled treatment visit, and at 3 months after completion of treatment
  
• Overall quality of life measured using Cantril's Ladder at baseline and 3 months after completion of treatment
  
• Coping measured by the Mini-Mental Adjustment to Cancer Scale (Mini-MAC) at baseline and 3 months after completion of treatment
  
• Hospitalizations, emergency department visits, and unscheduled clinic visits at each scheduled visit during treatment and at the 3-month post-treatment follow up
  
• Falls, injuries, and other complications at each scheduled visit during treatment and at the 3-month post-treatment follow up
  

OBJECTIVES:

Primary

• To establish an estimate of the prevalence of baseline neurocognitive impairment prior to initiation of outpatient cancer treatment.
• To establish an estimate of the incidence of neurocognitive impairment during outpatient cancer treatment.
• To describe how neurocognitive functioning changes over time during cancer treatment.

Secondary

• To identify sociodemographic and clinical factors associated with neurocognitive impairment.
• To examine health-related outcomes associated with neurocognitive impairment.

OUTLINE: Patients undergo interview to complete measures of domain-specific neurocognitive functioning, global neurocognitive functioning, subjective neurocognitive functioning, delirium, physical functioning, symptom prevalence and distress, mood states, and medications at baseline before initiation of cancer treatment, at scheduled treatment visits, and at the follow-up visit 3 months after completion of cancer treatment.

Measures of comorbidity, alcohol use, sensory functioning (vision and hearing), and sociodemographic are completed at baseline only. Cancer-related information (diagnosis, staging, and sites of metastasis, if applicable), treatment-related information (planned treatment regimen - chemotherapy and/or radiation therapy), and current medications are obtained at baseline by medical record review.

Health service use and complications are assessed at each scheduled treatment visit and at the 3-month post-treatment follow-up visit. Measures of domain-specific neurocognitive functioning, coping, and quality of life are completed at baseline and at the 3-month follow-up visit.