AUA 2019: Androgen-Deprivation Therapy and Risk to Cognitive Health
Posted: Friday, May 24, 2019
Men who receive androgen-deprivation therapy (ADT) for prostate cancer may be at an increased risk for developing all-cause dementia, Alzheimer’s disease, and use of psychiatric services, according to findings presented at the 2019 American Urological Association (AUA) Annual Meeting (Abstract PD30-12) in Chicago. Quoc-Dien Trinh, MD, of the Brigham and Women’s Hospital and the Harvard Medical School, Boston, additionally found that ADT longer than 7 months corresponded with a greater risk of effects on cognitive health.
“Androgen-deprivation therapy may not only cause physical changes—such as osteoporosis, cardiovascular disease, or obesity—but may also cause changes in cognition,” coauthor Karl Heinrich Tully, MD, said in an interview with U.S. News & World Report.
For the retrospective cohort study, the authors focused on Surveillance, Epidemiology, and End Results–Medicare linked data from 100,414 men 66 years of age and older who were diagnosed with localized and locally advanced prostate cancer. The majority of patients were white (84%). Patients were followed until the administrative end of treatment at 36 months or death. Men with a history of stroke, dementia, or use of psychiatric services were excluded from the study.
Of the cohort, 38% received ADT within 6 months of diagnosis. Receipt of any pharmacologic ADT was associated with a 22% increased risk of all-cause dementia (hazard ratio = 1.22), a 29% increased risk of Alzheimer’s disease (hazard ratio = 1.29), and a 15% increased risk of psychiatric services (hazard ratio = 1.15). ADT also had a dose-response relationship for the duration of 7 months or more with all-cause dementia and Alzheimer’s disease, with an increased risk of 30% and 41%, respectively, compared with patients who did not receive the therapy. That same dose-response relationship was not observed for the use of psychiatric services.
Disclosure: The study authors’ disclosure information may be found at auajournals.org.
