Dementia Risk Possibly Increased by Prostate Cancer Therapy
Researchers analyzed the outcome of dementia among prostate cancer patients exposed to ADT vs. a lesser-exposed comparison group.
A study published in Prostate Cancer and Prostatic Diseases suggests that androgen deprivation therapy (ADT) to treat prostate cancer may be associated with a higher risk of dementia.
Due to conflicting data from existing studies on ADT and the risk of dementia, researchers from the University of Pennsylvania School of Medicine conducted a systematic review of current literature evaluating this association from various global databases. They analyzed the outcome of dementia among prostate cancer patients exposed to ADT vs. a lesser-exposed comparison group (eg, ADT vs. no-ADT; continuous vs. intermittent ADT).
A total of 9 studies were included in the review of which 7 reported an adjusted effect estimate for the risk of dementia. Findings from the random-effects meta-analysis, which included 50,541 patients, demonstrated an increased risk of dementia among ADT patients (hazard ratio [HR] 1.47, 95% CI: 1.08–2.00;P=0.02). A separate meta-analysis for all-cause dementia showed an HR 1.46 (95% CI: 1.05–2.02; P<0.001) and an HR 1.25 (95% CI: 0.99–1.57; P=0.06) for Alzheimer's disease. No bias from small study effects was reported.
Overall, the composite data suggested that ADT for prostate cancer treatment may be tied to a higher risk of dementia. Lead author Kevin Nead, MD, MPhil, added, "The potential for neurocognitive deficits secondary to ADT should be discussed with patients and evaluated prospectively."
Nead KT, Sinha S, Nguyen PL. Androgen deprivation therapy for prostate cancer and dementia risk: a systematic review and meta-analysis [published online March 28, 2017]. Prostate Cancer Prostatic Dis. doi: 10.1038/pcan.2017.10.