- Men with prostate cancer given androgen deprivation therapy (ADT) had significantly elevated risk for all-cause dementia that was driven by use for more than a year.
Why this matters
- Approximately half of men with prostate cancer will receive ADT at some time.
- Better understanding of risks and benefits can help personalize therapy.
- Relative to peers not given ADT, men with prostate cancer given ADT had elevated risks (all HRs; 95% CIs) for:
- All-cause dementia: 1.21 (1.11-1.33).
- Alzheimer’s disease: 1.16 (1.09-1.24).
- Risk for all-cause dementia differed by ADT duration:
- Significant when given for >12 months: 1.36 (1.07-1.72).
- Not significant when given for ≤12 months: 1.06 (0.77-1.28).
- Risk for Alzheimer’s disease was not significantly elevated whether ADT was given for >12 months or for ≤12 months.
- Systematic review and meta-analysis of 14 prospective and retrospective cohort studies and randomized controlled trials among 2,068,315 men with any-stage prostate cancer.
- Main outcomes: all-cause dementia, Alzheimer’s disease.
- Funding: None.
- Heterogeneity in ADT type, patient populations.
- Limited numbers for duration-stratified analyses.
- Cutoffs other than 12 months were not assessed.
- Majority of studies conducted in US.
- Studies using intermittent ADT as control were excluded.