Possibly, physicians consider patients with severe cognitive problems to be less eligible for more intensive therapies. In this way “undertreatment”, “compliance”, and “complications” would act as intermediate factors in the relationship between cognition and survival.Īlthough cognition is not included as formal criterion for postoperative treatment decision-making in most clinical guidelines, cognition could influence the choice of therapy. Clinically based factors influencing patients’ cognitive impairments are therapeutic decision making, treatment compliance, and the risk of complications. The notion of cognitive functioning as marker for diffuse tumor infiltration, and the option that cognitive functioning and survival are determined by overlapping genetic pathways and biomarkers might play a role as biological factors. 3 Possible mechanisms underlying this relationship include both biologically and clinically based factors.

1, 2 In a recent study, we found these deficits to be independently, and possibly causally, related to survival in diffuse gliomas.

Cognitive deficits occur in all different grades of glioma and are most prevalent in the domains executive functioning and memory. A common and debilitating symptom is cognitive impairment, which is the result of multiple factors. Cognition, diffuse glioma, mediation-analyses, survivalĭiffuse glioma (WHO grade II-IV) are progressive and invariably fatal brain tumors, which shorten life expectancy and compromise patients’ quality of life through neurological symptoms.

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