{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T09:03:28Z","timestamp":1784538208809,"version":"3.55.0"},"reference-count":28,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,19]],"date-time":"2026-07-19T00:00:00Z","timestamp":1784419200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Older women with breast cancer carry a high burden of frailty, depressive symptoms and cognitive complaints, yet how these domains relate to one another in routine clinical practice remains incompletely understood. We examined the prevalence of positive frailty screening and its association with patient-reported cognitive function and asked whether depressive symptoms account for the apparent link between the two. Methods: We analyzed 314 women aged 65 years or older with stage IIB\u2013IIIC breast cancer who underwent a standardized geriatric assessment. Measures included the G8 screening tool, Vulnerable Elders Survey-13 (VES-13), Geriatric Depression Scale (GDS), Instrumental Activities of Daily Living (IADL), cognition and quality of life (FACT-Cog, FACT-G, and EORTC QLQ-C30). Associations were examined using correlation analyses, group comparisons, and multivariable linear regression. Results: Mean age was 72.9 years. A positive frailty screen (G8 \u2264 14) was present in 295 patients (93.9%), and 102 patients (32.5%) screened positive for depressive symptoms (GDS \u2265 5). G8 screening score correlated strongly with patient-reported cognitive function (Pearson r = 0.80, p &lt; 0.001), and patients with a positive frailty screen reported lower FACT-Cog scores than those with a negative screen (113.0 vs. 129.0, p &lt; 0.001). In multivariable analysis adjusted for age and G8 score, depressive symptoms emerged as the strongest independent correlate of FACT-Cog (\u03b2 = \u22120.89, p &lt; 0.001; model R2 = 0.90), whereas G8 screening score was no longer independently associated (p = 0.16). Patients with depressive symptoms had more than double the VES-13 vulnerability score of those without (7.8 vs. 3.6, p &lt; 0.001). Overall geriatric assessment profiles were generally comparable across the three exploratory treatment-era cohorts. Conclusions: In this cross-sectional analysis of older women with locally advanced breast cancer, depressive symptoms were the strongest independent correlate of patient-reported cognitive function. Incorporating a brief depression screen into routine geriatric assessment may represent a clinically actionable target that deserves further evaluation.<\/jats:p>","DOI":"10.3390\/jcm15145655","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T07:54:13Z","timestamp":1784534053000},"page":"5655","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Depressive Symptoms Are the Dominant Independent Correlate of Patient-Reported Cognitive Function in Older Women with Locally Advanced Breast Cancer: A Cross-Sectional Geriatric Assessment Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8040-300X","authenticated-orcid":false,"given":"Merve","family":"Tokocin","sequence":"first","affiliation":[{"name":"Department of General Surgery, Istanbul Bagcilar Training and Research Hospital, 34200 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3610-5472","authenticated-orcid":false,"given":"Kayra","family":"Cangoz","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Akdagmadeni Sehit Sinan Babacan State Hospital, 66300 Yozgat, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1953-4400","authenticated-orcid":false,"given":"Huseyin","family":"Kadioglu","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Kanuni Sultan Suleyman Training and Research Hospital, 34303 Istanbul, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"505","DOI":"10.2147\/CIA.S365494","article-title":"Frailty and Cancer: Current Perspectives on Assessment and Monitoring","volume":"18","author":"Goede","year":"2023","journal-title":"Clin. 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