New research findings suggest that a mainstay of prostate cancer treatment may be associated with an increased risk of dementia. Researchers found that the use of androgen deprivation therapy (ADT) is linked to a higher risk of dementia, a study published in JAMA Oncology states. ADT is given to as many as 500,000 men with prostate cancer; its use has increased significantly over the past few decades.
The study involved 9,272 men with prostate cancer who were not previously diagnosed with dementia between 1994 and 2013. By analyzing their medical records, researchers were able to study the relationship between ADT use and dementia. Among the entire cohort, 1,826 patients had ADT treatment. The average age was 66.8 years and 55.8 percent of the cohort was white. The authors found a statistically significant relationship between ADT use and dementia.
Kevin T. Nead, MD, of Stanford University School of Medicine led the study with colleagues. “ADT has a demonstrated survival benefit in some patients with prostate cancer. However, it also has been linked to several adverse health effects,” said Dr. Nead, according to Cancer Network. “A growing body of evidence supports a link between ADT and cognitive dysfunction, including Alzheimer disease.”
The median follow-up was 3.4 years; 314 men were diagnosed with dementia, which was diagnosed at a median time of 4 years. The risk of dementia was 7.9 percent in men taking ADT after 5 years, compared to 3.5 percent in men not using ADT. The risk of dementia was highest in men receiving at least 12 months of ADT therapy. The findings were similar when excluding patients with chemotherapy.
“We show a dose response effect between greater duration of use of ADT and increased risk of dementia. Finally, we find that use of ADT increases the risk of dementia regardless of age, but that older men receiving ADT were the least likely to remain dementia free,” authors said.
“This finding should be investigated in prospective studies given significant individual patient and health system implications if there are higher rates of dementia among the large group of patients undergoing ADT,” authors stated.