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International Bulletin of Otorhinolaryngology

Age as a factor for cognitive decline in patients with glial tumors

E. Moynova, Y. Enchev, M. Moynov, G. Stoyanov, B. Iliev, T. Kondev, S. Marianova, A. Demirci


Introduction: Cognitive impairment appears in almost all patients with glial tumors during the course of this neuro-oncological disease. There are various reasons for this in regards to the glial tumor: grade of malignancy, rate of growth, molecular nature, mass effect, and presence of perifocal edema. But these factors do not always correlate with the degree of patient’s cognitive impairment. The present study’s aim is to account for age as a factor in the occurrence of cognitive decline in patients with glial tumors.
Materials and methods: The study includes thirty two patients diagnosed with a glial tumor, treated operatively in the Neurosurgery Clinic of University hospital „St. Marina“ in Varna between 2019 and 2022 year. Twenty nine of those patients are diagnosed with glioblastoma, two are diagnosed with diffuse astrocytoma and one with astrocytoma grade 3 according to WHO. The mean age of the patients is 58.4 ± 11.4 years. The youngest patient is 25 years old and the oldest is 78 years old. Preoperatively, all patients are subjected to a series of cognitive tests.
Results: From the studied sample, patients diagnosed with glioblastoma showed lower cognitive scores compared to the patients diagnosed with other glial tumors. Patients diagnosed with glioblastoma are significantly older than the patients diagnosed with other glial tumors.
Conclusion: The older age of patients affected by glioblastoma may be an additional reason beside tumor factors for lower cognitive test outcome compared to patients affected by lower-grade gliomas.


glioblastoma, cognitive deficit, cognitive functions, age-related cognitive impairment

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Boone M, Roussel M, Chauffert B, le Gars D, Godefroy O. Prevalence and profile of cognitive impairment in adult glioma: a sensitivity analysis. J Neurooncol. 2016;129(1):123-130. doi:10.1007/s11060-016-2152-7

Tucha O, Smely C, Preier M, Lange KW. Cogntive deficits before treatment among patients with brain tumors. Neurosurgery. 2000;47(2):324-333. doi:10.1097/00006123-200008000-00011

Noll KR, Bradshaw ME, Weinberg JS, Wefel JS. Neurocognitive functioning is associated with functional independence in newly diagnosed patients with temporal lobe glioma. Neurooncol Pract. 2018;5(3):184-193. doi:10.1093/nop/npx028

Zucchella C, Bartolo M, di Lorenzo C, Villani V, Pace A. Cognitive impairment in primary brain tumors outpatients: A prospective cross-sectional survey. J Neurooncol. 2013;112(3):455-460. doi:10.1007/s11060-013-1076-8

L H Schwamm LH, Dyke C van, Kiernan RJ, Merrin EL, Mueller J. The Neurobehavioral Cognitive Status Examination: comparison with the Cognitive Capacity Screening Examination and the Mini-Mental State Examination in a neurosurgical population. 1987;107(4):486-491.

Noll KR, Ziu M, Weinberg JS, Wefel JS. Neurocognitive functioning in patients with glioma of the left and right temporal lobes. J Neurooncol. 2016;128(2):323-331. doi:10.1007/s11060-016-2114-0

Taphoorn MJ, Klein M. Cognitive deficits in adult patients with brain tumours. Lancet Neurol. 2004;3(3):159-168.

Klein M. Lesion momentum as explanation for preoperative neurocognitive function in patients with malignant glioma. Neuro Oncol. 2016;18(12):1595-1596. doi:10.1093/neuonc/now266

Talacchi A, Santini B, Savazzi S, Gerosa M. Cognitive effects of tumour and surgical treatment in glioma patients. J Neurooncol. 2011;103(3):541-549. doi:10.1007/s11060-010-0417-0

Wefel JS, Noll KR, Rao G, Cahill DP. Neurocognitive function varies by IDH1 genetic mutation status in patients with malignant glioma prior to surgical resection. Neuro Oncol. 2016;18(12):1656-1663. doi:10.1093/neuonc/now165

Murman DL. The Impact of Age on Cognition. Semin Hear. 2015;36(3):111-121. doi:10.1055/s-0035-1555115

Morshed RA, Young JS, Kroliczek AA, Berger MS, Brang D, Hervey-Jumper SL. A Neurosurgeon’s Guide to Cognitive Dysfunction in Adult Glioma. Neurosurgery. 2021;89(1):1-10. doi:10.1093/neuros/nyaa400

Louis DN, Ohgaki H, Wiestier OD, et al. WHO Classification of Tumours of the Central Nervous System.

Reuss DE, Mamatjan Y, Schrimpf D, et al. IDH mutant diffuse and anaplastic astrocytomas have similar age at presentation and little difference in survival: a grading problem for WHO. Acta Neuropathol. 2015;129(6):867-873. doi:10.1007/s00401-015-1438-8

Barresi V, Eccher A, Simbolo M, et al. Diffuse gliomas in patients aged 55 years or over: A suggestion for IDH mutation testing. Neuropathology. 2020;40(1):68-74. doi:10.1111/neup.12608



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