Chronic Vascular Comorbidities Are Associated With Higher Subjective Cognitive Decline Among Cancer Survivors With Subjective Functional Difficulties

Chronic vascular comorbidities are associated with subjective cognitive decline (SCD), yet less well studied in cancer survivors self-managing their everyday activities. This study aimed to examine the association between chronic vascular comorbidities and SCD in adults with cancer, and the role of subjective functional difficulties and psychological distress in that relationship. This study utilized the 2019 wave of the Behavioral Risk Factor Surveillance System dataset (N = 1293 adult cancer survivors, age = 65 to ≥80, 72.2% females). A serial pathway analysis examined the singular and joint mediation of subjective functional difficulties and psychological distress in cancer survivors with chronic vascular comorbidities and subjective functional difficulties. The results showed that chronic vascular comorbidities are associated with higher SCD. Functional difficulties alone contributed a substantially stronger indirect effect to the model than psychological distress. In the serial pathway model, psychological distress and subjective functional difficulties jointly contributed to lower subjective functional difficulties. Conclusion: Among cancer survivors with chronic vascular comorbidities, everyday activity limitations explain SCD primarily more than psychological distress alone.