Does Androgen-Deprivation Therapy for Prostate Cancer Increase Risk of Dementia?
Posted: Tuesday, October 27, 2020
Certain types of androgen-deprivation therapy (ADT) used to treat prostate cancer may be more likely than others to increase a person’s risk of dementia and Alzheimer’s disease, according to Wen-Kuan Huang, MD, of Chang Gung University College of Medicine, Taiwan, and colleagues. In particular, antiandrogen monotherapy alone was found to be associated with prostate cancer/dementia comorbidity. This research was published in JAMA Network Open.
“These findings suggest that the use of antiandrogen monotherapy, but not GnRH agonist or orchiectomy, requires more attention with respect to subsequent risk of dementia,” the authors commented.
Although antiandrogen monotherapy was associated with an increased risk of a diagnosis of dementia, the authors noted that this was “…during a limited period after antiandrogen treatment initiation. However, there was no sustained increased risk with longer treatment duration. This indicates that ADT may exacerbate the preexisting neurodegeneration process.”
This retrospective study included 23,651 men from Taiwan (median age of 73 years) who had been newly diagnosed with prostate cancer. The cohort was separated into groups that did not receive ADT or received differing types of ADT: antiandrogen monotherapy, gonadotropin-releasing hormone (GnRH) agonists, or orchiectomy. At the median follow-up of 3.46 years, 15.5% of these patients had been diagnosed with incident dementia.
Researchers found that the use of antiandrogen monotherapy to treat patients with prostate cancer increased the risk of developing both dementia (weighted hazard ratio = 1.34) and Alzheimer’s disease (weighted hazard ratio = 1.52), compared with those who did not receive ADT. However, there were seemingly no differences in dementia diagnoses between the groups that received no ADT, GnRH agonists (weighted hazard ratio = 1.13), or orchiectomy (weighted hazard ratio = 1.00).
Disclosure: The study authors reported no conflicts of interest.