Androgen Deprivation Therapy May Up Risk of Alzheimer Disease
TUESDAY, July 9, 2019 -- Among elderly patients with prostate cancer, androgen deprivation therapy (ADT) exposure is associated with subsequent diagnosis of Alzheimer disease or dementia, according to a study published online July 3 in JAMA Network Open.
Ravishankar Jayadevappa, Ph.D., from the University of Pennsylvania in Philadelphia, and colleagues used data from the National Cancer Institute Surveillance, Epidemiology, and End Results Medicare-linked database to identify 154,089 elderly men newly diagnosed with prostate cancer (1996 to 2003). Diagnosis of Alzheimer disease or dementia was compared among men who received ADT (62,330 patients) within two years of diagnosis and those who did not (91,759 patients).
The researchers found that during a mean follow-up of 8.3 years, exposure to ADT was associated with a diagnosis of Alzheimer disease (13.1 versus 9.4 percent; hazard ratio, 1.14) and dementia (21.6 versus 15.8 percent; hazard ratio, 1.20). The hazard ratio was significant for all ADT doses: For one to four doses, the hazard ratio was 1.19 for both Alzheimer disease and dementia; for five to eight doses, the hazard ratios were 1.28 and 1.24, respectively; and for more than eight doses, the hazard ratios were 1.24 and 1.21, respectively. For Alzheimer disease, the number needed to harm was 18 patients compared with 10 patients for dementia.
"Clinicians must carefully weigh the long-term risks and benefits of exposure to ADT in patients with a prolonged life expectancy and stratify patients by dementia risk prior to ADT initiation," the authors write.
One author disclosed financial ties to the pharmaceutical industry.
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Posted: July 2019