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December 16, 2015
ADT for Prostate Cancer Linked to Significantly Greater Alzheimer’s Risk

Philadelphia—The risk of developing Alzheimer’s disease increased in men treated with androgen-deprivation therapy (ADT) for prostate cancer, especially those who took testosterone-lowering medications for longer periods of time, according to a new study.

The analysis of medical records from two large hospital systems, published recently in the Journal of Clinical Oncology, revealed that patients using ADT were almost twice as likely to be diagnosed with Alzheimer’s disease in the years that followed, compared to those who didn't undergo the therapy. In addition, the risk shot up with longer duration of treatment.

While the study doesn’t prove that ADT increases the risk of Alzheimer's disease, results suggest that possibility, and are in line with other evidence that low levels of testosterone can weaken the aging brain's resistance to Alzheimer's, according to researchers from the University of Pennsylvania School of Medicine in Philadelphia and Stanford University School of Medicine in Stanford, California.

“We wanted to contribute to the discussion regarding the relative risks and benefits of ADT, and no one had yet looked at the association between ADT and Alzheimer's disease,” said lead author Kevin T. Nead, MD, MPhil, a medical resident and a fellow at Penn's Leonard Davis Institute of Health Economics. “Based on the results of our study, an increased risk of Alzheimer's disease is a potential adverse effect of ADT, but further research is needed before considering changes to clinical practice.”

Background information in the articles notes that about half a million men in the United States are taking ADT at any given time to help stem the growth of prostate tumors. The treatment has a range of adverse side effects, however, including impotence, obesity, diabetes, high blood pressure, heart disease, and depression.

Recent research has linked low testosterone to cognitive deficits, pointing out that men with Alzheimer's tend to have lower testosterone levels, compared to men of the same age without the disease.

For the study, researchers evaluated medical records from the Stanford health system and Mt. Sinai Hospital in New York, which included about five million patients, 16,888 of whom received a diagnosis of prostate cancer and met all the other criteria for the study.

The 2,400 men who had received ADT and had the necessary follow-up records were matched according to age and other factors with a control group of prostate cancer patients who had not received ADT. Statistical analysis indicates that the ADT group had significantly more Alzheimer's diagnoses in the years following initiation of that therapy, indicating that their likelihood of developing the cognitive disease was about 88% higher than the control group. The risk was doubled for patients who took ADT for longer durations, according to the results.

“It's hard to determine the precise amount of increased risk in just one study and important to note that this study does not prove causation,” Nead said in a Penn Medicine press release. “But considering the already-high prevalence of Alzheimer's disease in older men, any increased risk would have significant public health implications.”


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