New research may ease concerns that androgen deprivation therapy (ADT) contributes to dementia in patients with prostate cancer (PCa).
Among 45,218 veterans who received definitive radiotherapy, with or without ADT, for non-metastatic PCa, vascular dementia developed in 335 patients, Alzheimer disease in 404, and any other dementia in 758 over a median of 6.8 years. A regression model showed no statistically significant associations between ADT use and any form of dementia. Length of ADT use, whether 1 year or longer, did not alter the results. Investigators adjusted the model for demographics, Charlson Comorbidity Index score, and use of statins, antiplatelets, antihypertensives, alcohol, tobacco, and other substances.
“These results may mitigate concerns regarding the long-term risks of ADT on cognitive health in the treatment of PC,” Rishi Deka, PhD, of Veterans Affairs San Diego Health Care System, and his colleagues concluded in the JAMA Oncology.
With regard to study limitations, the authors noted that they only looked at patients who received radiotherapy, so results may not be generalizable to patients with PCa treated with another modality. In addition, their study population included only veterans, so some differences in sociodemographic factors may exist that limit generalizability of results to the larger population of men with PCa.
Deka R, Simpson DR, Bryant AK, et al. Association of androgen deprivation therapy with dementia in men with prostate cancer who receive definitive radiation therapy. JAMA Oncol. 2018; published online ahead of print.doi:10.1001/jamaoncol.2018.4423