Cognition, Vascular Function, and Physical Activity in Colorectal Cancer Survivors - Colorectal cancer (CRC) is the 3rd most common cancer in the United States for both male and females. Advancements in treatment options are successfully helping CRC survivors (CRCS; post treatment) live longer with currently 1.4 million CRCS in the United States. Despite living longer CRCS are experiencing negative psychological (i.e., cognitive impairments) and physiological (i.e., arterial stiffness) of the disease. CRCS experience impairments in aspects of cognition including cognitive processing speed (CPS), learning and memory, and executive function with CPS being the most impaired cognitive domain. CRCS further experience increased levels of arterial stiffness particularly measures of carotid-femoral pulse wave velocity (cfPWV). Physical activity (PA) is recommended following a cancer diagnosis to improve quality of life, alleviate symptoms of cancer and treatment, and decrease risk for recurrence and development of comorbidities including hypertension, diabetes, and hyperlipidemia; however, levels of PA are reduced in CRCS. In the general population and diseased populations moderate-to-vigorous PA (MVPA) is associated with improvement in various domains of cognition including CPS and better outcomes of arterial stiffness, particularly cfPWV suggesting that MVPA may occupy a similar beneficial role for CRCS and alleviate side effects and improve quality of life and longevity. The proposed cross-sectional, comparative research study is guided by the central hypothesis that CRCS will exhibit (a) worse vascular and cognitive function and lower PA levels than matched controls, and (b) stronger associations among those variables that will support (c) analyses of vascular function as a mediator of the association between PA and cognition in CRCS. The following aims will be tested (1) compare CPS, cfPWV, and MVPA between CRCS and matched controls; (2) examine the associations among CPS, cfPWV, and MVPA; and (3) determine if cfPWV serves a mediator of the association between MVPA and CPS. The following training goals will guide the completion of this study including: (i) didactic and experiential training in the CRC progression, development, treatment options and survivorship; (ii) clinical training in the administration, scoring, and interpretation of neuropsychological tests from the International Cancer Cognition Task Force battery; (iii) educational and clinical training to further understand the clinical application of cardiovascular function and risks; and (iv) research training in the initialization, calibration, data processing, and interpretation of Actigraph accelerometers. The outcomes of this study will highlight the importance of cognition, vascular function, and PA levels and associations in CRCS as well as lay a foundation for future research on PA behavioral interventions in this population. The proposed research and training goals with my collaborating team will help me achieve my short-term goal of completing the proposed study and support my long-term goal of receiving a faculty and research position in the field of exercise oncology.
