Stanford, CA—For some patients with prostate cancer, androgen-deprivation therapy (ADT) can prolong survival. Those benefits might come at a cost, however, because the treatment also has been associated with some adverse health effects and a possible increase in neurocognitive dysfunction.
To help quantify that information, a new study published online by JAMA Oncology used an informatics approach with a text-processing method to analyze electronic medical records data to examine ADT and the subsequent development of dementia, including senile dementia, vascular dementia, frontotemporal dementia, and Alzheimer dementia.
The study, led by a researcher at the Stanford University School of Medicine, focused on data from an academic medical center from 1994 to 2013, with the final study group including 9,272 men with prostate cancer—19.7% of them receiving ADT.
During a median follow-up of 3.4 years, 314 new cases of dementia were documented, with a median time to dementia of 4 years.
Results indicate that the absolute increased risk of developing dementia among those men who received ADT was 4.4% at 5 years. Men who received ADT for at least 12 months had the greatest absolute increased risk of dementia, according to further analysis, which also determined that men ≥70 years of age who received ADT were the least likely to remain free of dementia.
Study authors posit several possible associations between ADT and dementia in general, including that androgens have a demonstrated role in neuronal health and growth. Because of the study’s design however, a causal association between the use of ADT and the risk of dementia cannot be determined, they caution.
“Our study extends previous work supporting an association between use of ADT and Alzheimer disease and suggests that ADT may more broadly affect neurocognitive function,” the researchers write. “This finding should be investigated in prospective studies given significant individual patient and health system implications if there are higher rates of dementia among the large groups of patients undergoing ADT.”
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