• Domain-Specific Neurocognitive Functioning measuring attention, executive functioning, mental processing speed, verbal memory, language, and visuospatial construction at baseline and 3 months after completion of treatment [ Time Frame: Baseline and 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Global neurocognitive functioning as measured by the Mini-Mental State Examination (MMSE) [ Time Frame: Baseline, at each scheduled treatment visit, and at 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Self-reported neurocognitive symptoms as measured by the Alertness Behavior Subscale of the Sickness Impact Profile [ Time Frame: Baseline, at each scheduled treatment visit, and at 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Delirium and delirium symptoms by the NEECHAM Confusion Scale and Confusion Assessment Method (CAM) [ Time Frame: Baseline, at each scheduled treatment visit, and at 3 months post-treatment ] [ Designated as safety issue: No ]
  

• Alcohol, tobacco, and drug use as measured by the Alcohol Use Disorders Identification Test (AUDIT) [ Time Frame: Baseline ] [ Designated as safety issue: No ]
  
• Premorbid intellectual functioning as measured by the North American Adult Reading Test (NAART) [ Time Frame: Baseline ] [ Designated as safety issue: No ]
  
• Functional status measured by the Duke Older Americans Resources and Services (OARS) Activities of Daily Living Scale [ Time Frame: Baseline, at each scheduled treatment visit, and at 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Symptom prevalence and distress measured using the short form of the Memorial Symptom Assessment Scale (MSASSF) [ Time Frame: Baseline, at each scheduled treatment visit, and at 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Mood State measured by the Profile of Mood States (POMS-SF) [ Time Frame: Baseline, at each scheduled treatment visit, and at 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Overall quality of life measured using Cantril's Ladder [ Time Frame: Baseline and 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Coping measured by the Mini-Mental Adjustment to Cancer Scale (Mini-MAC) [ Time Frame: Baseline and 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Hospitalizations, emergency department visits, and unscheduled clinic visits [ Time Frame: At each scheduled treatment visit and 3 months post-treatment ] [ Designated as safety issue: No ]
  
• Falls, injuries, and other complications [ Time Frame: At each scheduled treatment visit and 3 months post-treatment ] [ Designated as safety issue: No ]
  

OBJECTIVES:

Primary

• To establish an estimate of the prevalence of baseline neurocognitive impairment prior to initiation of outpatient cancer treatment.
• To establish an estimate of the incidence of neurocognitive impairment during outpatient cancer treatment.
• To describe how neurocognitive functioning changes over time during cancer treatment.

Secondary

• To identify sociodemographic and clinical factors associated with neurocognitive impairment.
• To examine health-related outcomes associated with neurocognitive impairment.

OUTLINE: Patients undergo interview to complete measures of domain-specific neurocognitive functioning, global neurocognitive functioning, subjective neurocognitive functioning, delirium, physical functioning, symptom prevalence and distress, mood states, and medications at baseline before initiation of cancer treatment, at scheduled treatment visits, and at the follow-up visit 3 months after completion of cancer treatment.

Measures of comorbidity, alcohol use, sensory functioning (vision and hearing), and sociodemographic are completed at baseline only. Cancer-related information (diagnosis, staging, and sites of metastasis, if applicable), treatment-related information (planned treatment regimen - chemotherapy and/or radiation therapy), and current medications are obtained at baseline by medical record review.

Health service use and complications are assessed at each scheduled treatment visit and at the 3-month post-treatment follow-up visit. Measures of domain-specific neurocognitive functioning, coping, and quality of life are completed at baseline and at the 3-month follow-up visit.