Abstract
<title>Abstract</title> <p>Background Cancer-related cognitive impairment (CRCI) is a common survivorship concern among patients with ovarian cancer. Social support may be associated with CRCI, but the psychological factors that may explain this association remain unclear. Objective To examine the prevalence of cancer-related cognitive impairment (CRCI) among surgical patients with ovarian cancer in China, assess its association with social support, and explore whether anxiety, depressive symptoms, and sleep quality statistically accounted for this association. Methods This cross-sectional study included 360 patients with ovarian cancer who underwent surgery at Gansu Provincial Maternal and Child Health Care Hospital. Subjective cognition was assessed using the FACT-Cog PCI subscale, and objective cognition was evaluated using the MoCA and Trail Making Tests. Social support, anxiety, depressive symptoms, and sleep quality were also measured. Multivariable logistic regression and exploratory indirect-effect analyses were performed. Because the data were cross-sectional, indirect effects were interpreted as exploratory and not as evidence of causal mediation. Results PCI-defined CRCI was identified in 33.1% of patients, while 65.3% showed cognitive impairment on the MoCA. The prevalence of PCI-defined CRCI decreased as social support increased. Compared with low social support, high social support was significantly associated with lower odds of CRCI (OR = 0.260, 95% CI: 0.124–0.545, p < .001). Exploratory indirect-effect analysis showed that depressive symptoms accounted for part of the association between high social support and CRCI, whereas anxiety and sleep quality did not show significant indirect effects. Conclusion CRCI is common among surgical patients with ovarian cancer. Higher social support was associated with lower odds of CRCI, and depressive symptoms may help explain part of this association. Longitudinal studies are needed to test the temporal and causal pathways among social support, depressive symptoms, and cognitive outcomes.</p>