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Higher Dementia, Depression Risk Among Patients Given ADT for Prostate Cancer
Risk for dementia and depression is higher among patients who underwent androgen deprivation therapy (ADT) for prostate cancer than those who did not undergo ADT (Eur Urol Oncol. 2019;S2588-9311[19]30129-4).
“Previous studies have found an association between [ADT] and an increased risk of dementia and depression in elderly men. This association remains controversial, and little is known about the effects of ADT in younger men,” explained Karl H. Tully, MD, Division of Urological Surgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, and colleagues.
In order to examine the association between ADT and risk of dementia and depression in young patients, Dr Tully and colleagues conducted an observational study that identified 9117 men between 40-64 years of age diagnosed with localized prostate cancer, between 2007 and 2014, from the TRICARE military database.
Kaplan-Meier curves were fitted to compare patients who received ADT to those who did not. A subgroup analysis was performed in patients undergoing ADT for ≥12 months. Inverse probability of weight-adjusted Cox proportional hazards regression analysis was used to evaluate the association between ADT and new-onset depression or dementia.
Results showed that patients receiving ADT had a significantly higher incidence of depression (30.2 vs 15.8 per 1000 person years) and dementia (17.9 vs 7.5 per 1000 person years). ADT was also associated with a significantly higher risk for developing depression (Hazard ratio [HR] 2.07, P<0.001) and dementia (HR 1.70, P=0.052).
Additionally, a dose-response relationship was observed between ADT duration and either depression or dementia.
“In our cohort of young men with PCa [prostate cancer], the receipt of ADT was associated with an increased risk of developing dementia and depression. Long-term use of ADT was associated with the highest risk of neurocognitive outcomes,” concluded Dr Tully and colleagues.—Janelle Bradley
