Jhen-Hao Jhan1,2, Yuan-Han Yang3, Yu-Han Chang4, Shiao-Jin Guu1,2, Chia-Chun Tsai1,2,5. 1. a Department of Urology , School of Medicine, College of Medicine, Kaohsiung Medical University , Kaohsiung , Taiwan. 2. b Department of Urology , Kaohsiung Medical University Hospital , Kaohsiung , Taiwan. 3. c Department of Neurology , Kaohsiung Municipal Ta-Tung Hospital , Kaohsiung , Taiwan. 4. d Kaohsiung Municipal Ta-Tung Hospital, Management Offices , Kaohsiung , Taiwan , and. 5. e Department of Urology , Kaohsiung Municipal Ta-Tung Hospital , Kaohsiung , Taiwan.
Abstract
INTRODUCTION: Androgen-deprivation therapy (ADT) is recognized to be the preferred first-line treatment for advanced prostate cancer. However, the risk-benefit ratio of ADT remains poorly defined and the relationship between androgen depletion and dementia is not clear. AIM: To investigate the risk of developing Alzheimer's disease (AD) in patients undergoing ADT for prostate cancer. METHODS: Data from 24 360 prostate cancer patients were collected from the Longitudinal Health Insurance Database of Taiwan. In total, 15 959 patients who underwent ADT were included in the study cohort, and another 8401 patients who did not receive ADT were included as a non-ADT cohort. RESULTS: During the average 4-year follow-up period, the incidence of AD was 2.78 per 1000 person-years in the non-ADT cohort and 5.66 per 1000 person-years in the ADT cohort. After adjusting for age and all comorbidities, the combined ADT cohort was found to be 1.84 times more likely to develop AD than the non-ADT control group (95%CI 1.33-2.55, p < 0.001). CONCLUSIONS: The present results suggest that ADT use is associated with an increased risk of developing AD.
INTRODUCTION: Androgen-deprivation therapy (ADT) is recognized to be the preferred first-line treatment for advanced prostate cancer. However, the risk-benefit ratio of ADT remains poorly defined and the relationship between androgen depletion and dementia is not clear. AIM: To investigate the risk of developing Alzheimer's disease (AD) in patients undergoing ADT for prostate cancer. METHODS: Data from 24 360 prostate cancerpatients were collected from the Longitudinal Health Insurance Database of Taiwan. In total, 15 959 patients who underwent ADT were included in the study cohort, and another 8401 patients who did not receive ADT were included as a non-ADT cohort. RESULTS: During the average 4-year follow-up period, the incidence of AD was 2.78 per 1000 person-years in the non-ADT cohort and 5.66 per 1000 person-years in the ADT cohort. After adjusting for age and all comorbidities, the combined ADT cohort was found to be 1.84 times more likely to develop AD than the non-ADT control group (95%CI 1.33-2.55, p < 0.001). CONCLUSIONS: The present results suggest that ADT use is associated with an increased risk of developing AD.
Entities:
Keywords:
Alzheimer’s disease; Androgen-deprivation therapy (ADT); prostate cancer
Authors: Ravishankar Jayadevappa; Sumedha Chhatre; S Bruce Malkowicz; Ravi B Parikh; Thomas Guzzo; Alan J Wein Journal: JAMA Netw Open Date: 2019-07-03