Association Between Androgen Deprivation Therapy Use and Diagnosis of Dementia in Men With Prostate Cancer

Abstract

Key Points Question Is androgen deprivation therapy exposure associated with dementia among elderly patients with prostate cancer? Findings In this cohort study of 154 089 elderly men with prostate cancer, androgen deprivation therapy exposure was associated with subsequent diagnosis of Alzheimer disease or dementia over a follow-up period of at least 10 years. Meaning Clinicians must carefully weigh the long-term risks and benefits of exposure to androgen deprivation therapy in patients with a prolonged life expectancy and stratify patients by dementia risk prior to androgen deprivation therapy initiation.

Co-occurrent Alterations of Alzheimer's Genes and Prostate Cancer Genes in Prostate Cancer

“…The study suggests an association between ADT and subsequent dementia but does not investigate possible biological mechanisms of the association. The authors conclude that clinicians need to carefully weigh the longterm risks and benefits of exposure to ADT in patients with a prolonged life expectancy and stratify patients based on dementia risk prior to ADT initiation (8).…”

“…Yet the risk of impaired cognition or Alzheimer's disease in men with prostate cancer receiving ADT is uncertain (1). Some studies of prostate cancer and ADT suggest that risk of Alzheimer's disease is not increased (2-5), although others have found increased risk of Alzheimer's disease and cognitive impairment (6)(7)(8).…”

An Updated Review: Androgens and Cognitive Impairment in Older Men

“…After ADT treatment, cognitive impairment occurs within 6 and 12 months, and the risk for dementia is greatest when ADT exceeds 12 months (38,39). Compared with non-ADT patients, the risk for dementia in patients with ADT increases by 4.4 and 5.8% within follow-up periods of 5 and 8.3 years, respectively (38)(39)(40). Additionally, generally, the higher the dose of ADT is, the higher the risk of dementia (40).…”

“…Compared with non-ADT patients, the risk for dementia in patients with ADT increases by 4.4 and 5.8% within follow-up periods of 5 and 8.3 years, respectively (38)(39)(40). Additionally, generally, the higher the dose of ADT is, the higher the risk of dementia (40). AD is a serious type of dementiarelated disease.…”

“…AD is a serious type of dementiarelated disease. Multiple studies have also shown that AD risk in the ADT group is 1.14-1.84 times higher than that in the non-ADT group after adjusting for confounding factors (40)(41)(42). Patients over 70 years of age have the greatest risk for AD after ADT compared with patients under 70 years of age (43).…”