Multiple factors contribute to these cognitive changes. Moreover, some patients have been found to have poorer cognitive function than their healthy counterparts when they aware about their cancer diagnosis before they began therapy, [1] pointing to the possibility that factors other than treatment are contributing to the problem with higher level of death rumination.\r\nCognitive function is also interrelated with mood and functional ability. In particular, if someone reports a significant deterioration in cognitive function, [2] they are more likely to also experience worsening mood with death-rumination disorder. Conversely, individuals who are clinically depressed commonly experience poorer attention, thinking, and psychomotor slowing.\r\nSelf-reported death-rumination by cognitive problems may also be associated with other symptoms, such as sleep disturbance, and pain. Moreover, poorer cognitive function may be related to medications taken to manage these symptoms.\r\nPatients receiving higher-dose therapy or a longer duration of therapy, particularly with some biologic agents, are also at increased risk for cognitive change. Similarly, patients receiving concurrent chemo, radiation or therapy delivered directly to the central nervous system are at greater risk. [1] Other factors that increase patients’ risk of cognitive issues include behavior change and death-rumination.\r\n
