Androgen Deprivation Tx and Dementia: Is There a Link?
A study published in Prostate Cancer and Prostatic Diseases suggests that androgen deprivation therapy (ADT) to treat prostate cancer may be associated with a higher risk of dementia.
Due to conflicting data from existing studies on ADT and the risk of dementia, researchers from the University of Pennsylvania School of Medicine conducted a systematic review of current literature evaluating this association from various global databases. They analyzed the outcome of dementia among prostate cancer patients exposed to ADT vs. a lesser-exposed comparison group (eg, ADT vs. no-ADT; continuous vs. intermittent ADT).
A total of 9 studies were included in the review of which 7 reported an adjusted effect estimate for the risk of dementia. Findings from the random-effects meta-analysis, which included 50,541 patients, demonstrated an increased risk of dementia among ADT patients (hazard ratio [HR] 1.47, 95% CI: 1.08–2.00;P=0.02). A separate meta-analysis for all-cause dementia showed an HR 1.46 (95% CI: 1.05–2.02; P<0.001) and an HR 1.25 (95% CI: 0.99–1.57; P=0.06) for Alzheimer's disease. No bias from small study effects was reported.
Overall, the composite data suggested that ADT for prostate cancer treatment may be tied to a higher risk of dementia. Lead author Kevin Nead, MD, MPhil, added, "The potential for neurocognitive deficits secondary to ADT should be discussed with patients and evaluated prospectively."
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