Dementia: cognitive impact of ADT may hinge on duration

  • Sari Motlagh R & al.
  • J Urol
  • 28/08/2020

  • Susan London
  • Clinical Essentials
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Takeaway

  • Men with prostate cancer given androgen deprivation therapy (ADT) had significantly elevated risk for all-cause dementia that was driven by use for more than a year.

Why this matters

Key results

  • Relative to peers not given ADT, men with prostate cancer given ADT had elevated risks (all HRs; 95% CIs) for:
    • All-cause dementia: 1.21 (1.11-1.33).
    • Alzheimer’s disease: 1.16 (1.09-1.24).
  • Risk for all-cause dementia differed by ADT duration:
    • Significant when given for >12 months: 1.36 (1.07-1.72).
    • Not significant when given for ≤12 months: 1.06 (0.77-1.28).
  • Risk for Alzheimer’s disease was not significantly elevated whether ADT was given for >12 months or for ≤12 months.

Study design

  • Systematic review and meta-analysis of 14 prospective and retrospective cohort studies and randomized controlled trials among 2,068,315 men with any-stage prostate cancer.
  • Main outcomes: all-cause dementia, Alzheimer’s disease.
  • Funding: None.

Limitations

  • Heterogeneity in ADT type, patient populations.
  • Limited numbers for duration-stratified analyses.
  • Cutoffs other than 12 months were not assessed.
  • Majority of studies conducted in US.
  • Studies using intermittent ADT as control were excluded.