Prostate cancer: ADT not tied to Alzheimer's dementia

  • Robinson D & al.
  • BJU Int
  • 13 Jan 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Androgen deprivation therapy (ADT) was not associated with increased risk for Alzheimer's dementia in patients with prostate cancer.
  • Patients who received gonadotropin-releasing hormone (GnRH) agonists or orchiectomy showed higher risk for non-Alzheimer's dementia.

Why this matters

  • Findings may ease concerns regarding the effect of ADT on cognitive health.

Study design

  • Study of 25,967 men with prostate cancer and 121,018 men without prostate cancer.
  • Funding: Swedish Research Council; The Swedish Cancer Society; others.

Key results

  • Median follow-up time, 4.3 years.
  • 7209 patients were managed with watchful-waiting, 6982 received primary GnRH agonist, and 705 men underwent orchiectomy; 7703 of men initially managed with curative intent or watchful-waiting subsequently received ADT.
  • Risk for dementia was not statistically significant in men on watchful waiting (HR, 0.99; 95% CI, 0.89-1.10) and those receiving antiandrogens (HR, 0.94; 95% CI, 0.84-1.05) compared with men without prostate cancer.
  • Risk for dementia was significantly higher in men who received GnRH agonists (HR, 1.15; 95% CI, 1.07-1.23) and orchiectomy (HR, 1.60; 95% CI, 1.32-1.93) vs men without prostate cancer.
  • In subgroup analysis by dementia type, higher risk was observed for non-Alzheimer's dementia only: GnRH-agonists, HR 1.24 (95% CI, 1.14-1.36); orchiectomy, HR 1.79 (95% CI, 1.42-2.25).

Limitations

  • Observational design.

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