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Does Androgen-Deprivation Therapy Increase the Risk for Dementia in Patients With Prostate Cancer?

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Key Points

  • No significant association between androgen-deprivation therapy use and dementia was observed in patients with prostate cancer.
  • There was no apparent association between the duration of use or type of androgen-deprivation therapy and dementia risk.

In a UK population–based study reported in the Journal of Clinical Oncology, Khosrow-Khavar et al found no significant association between the use of androgen-deprivation therapy and the risk for dementia in patients with prostate cancer.

The study involved a cohort of 30,903 men with newly diagnosed nonmetastatic prostate cancer diagnosed between April 1988 and April 2015 from the UK’s Clinical Practice Research Datalink. Follow-up was through April 2016. Risk analysis was adjusted for age; alcohol-related disorders; smoking status; body mass index; modified Charlson comorbidity index; prostate-specific antigen; history of head injury; use of antidepressants, antipsychotics, benzodiazepines, and hypnotics; and a year of prostate cancer diagnosis.

No Increased Risk

Mean follow-up was 4.3 years. Overall, 799 patients had a new diagnosis of dementia (incidence = 6.0/1,000 person-years). Compared with nonuse, androgen-deprivation therapy use was not associated with an increased risk for dementia (incidence = 7.4 vs 4.4/1,000 person-years, adjusted hazard ratio [HR] = 1.02, 95% confidence interval [CI] = 0.87–1.19). In secondary analyses, the risk did not vary significantly according to the duration of androgen-deprivation therapy use (adjusted hazard ratios ranging from 0.84 to 1.05, with none being significant; P = .78 for heterogeneity) or according to the type of androgen-deprivation therapy (adjusted hazard ratios ranging from 0.69 to 1.06, none significant).

The investigators concluded: “In this population-based study, the use of [androgen-deprivation therapy] was not associated with an increased risk of dementia. Additional studies in different settings are needed to confirm these findings.”

The study was supported by a grant from the Canadian Institutes of Health Research.

Laurent Azoulay, PhD, of the Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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