ADT and dementia

[kaptank]

A bit of good news-ish.

practiceupdate.com/C/79098/...

OBJECTIVES

To study if androgen deprivation therapy (ADT), the mainstay treatment for advanced and disseminated prostate cancer, is associated with risk of dementia.

METHODS

Risk of dementia in men with prostate cancer primarily managed with ADT or watchful waiting (WW) in Prostate Cancer data Base Sweden (PCBaSe) was compared with that of prostate cancer-free men, matched on birth year and county of residency. We used Cox's regression to calculate hazard ratios for Alzheimer's and non-Alzheimer's dementia (vascular dementia, dementia secondary to other diseases or unspecified dementias) for different types and duration of ADT and oral antiandrogens as well as for men managed with watchful waiting.

RESULTS

25 967 men with prostate cancer and 121 018 prostate cancer-free men were followed for a median time of four years, and in both groups 6% of the men were diagnosed with dementia. Use of Gonadotropin-releasing hormone agonists (GnRH agonists, Hazard Ratio (HR): 1.15 (95%CI: 1.07-1.23) and orchiectomy, HR 1.60 (95%CI: 1.32-1.93) were associated with an increased risk of dementia, as compared to prostate cancer-free men. However, this increase in risk was only observed for non-Alzheimer's dementia and occurred from year one to four after start of ADT. No increase in for any type of dementia was observed for men treated with antiandrogens or for men on WW.

CONCLUSION

This population-based cohort study does not support previous observations of an increased risk of Alzheimer's dementia for men on ADT. However, there was a small increase in risk of non-Alzheimer's dementia.

[FCoffey]

I find no comfort in the knowledge that ADT via GnRH agonists significantly increases the odds that my mind will be destroyed by non-Alzheimer's dementia.

[kaptank]

I thought the results far more positive than I expected. We all accept a cognitive (and physical) decline but it seems its not overly due to ADT. Damn! I have been blaming my innate stupidity on the treatment.

A year or so ago we had studies showing a connection and a fair bit of concern about ADT and cognitive decline. The Swedish database is very large and detailed. It shows no alzheimer connection and a weak non alzheimer dementia correlation for the first 4 years of ADT. It doesn't make ADT any nicer though.

[j-o-h-n]

I say , Aw...... forget it....

Good Luck, Good Health and Good Humor.

j-o-h-n Thursday 02/14/2019 7:52 PM EST