15 Oct Androgen Deprivation For Prostate Cancer Linked to Dementia
MedicalResearch.com Interview with:
Kevin T. Nead, MD, MPhil
Resident, Radiation Oncology
Perelman School of Medicine
Hospital of the University of Pennsylvania.
MedicalResearch.com: What is the background for this study?
Response: Androgen deprivation therapy is a primary treatment for prostate cancer and works by lowering testosterone levels. There is a strong body of research suggesting that low testosterone can negatively impact neurovascular health and function. We were therefore interested in whether androgen deprivation therapy is associated with dementia through an adverse impact on underlying neurovascular function.
MedicalResearch.com: What are the main findings?
Response: We analyzed electronic medical record data in 1.2 million patients at Stanford University Hospital. We found that after diagnosis individuals with prostate cancer who were treated with androgen deprivation therapy had a significantly increased risk of developing dementia compared to those not treated with androgen deprivation therapy. That risk was greatest among older individuals and among those on androgen deprivation therapy the longest.
MedicalResearch.com: What should readers take away from your report?
Response: Multiple studies now suggest that androgen deprivation therapy may be associated with cognitive changes. The current study supports the association between androgen deprivation therapy and cognitive changes by showing an association between androgen deprivation therapy and dementia. This reinforces the need for further evaluation of this association in prospective studies. We would, however, not recommend changes to clinical practice based on this study alone given that androgen deprivation therapy is a life extending treatment in some men with prostate cancer.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Future research should replicate our findings as a first step. Ultimately, evaluation of this association in prospective studies will be needed to determine whether androgen deprivation therapy causes dementia and whether this should impact patient care.
MedicalResearch.com: How would androgen deprivation therapy cause dementia?
Response: Androgen deprivation therapy lowers testosterone levels. Testosterone and testosterone analogues have been shown to be directly neuroprotective. Low testosterone and androgen deprivation therapy have also been shown to increase cardiometabolic disease, which is an independent risk factor for dementia by impacting neurovascular function. Through these mechanisms androgen deprivation therapy may globally decrease neurovascular function thereby increasing the risk of dementia.
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Nead KT, Gaskin G, Chester C, Swisher-McClure S, Leeper NJ, Shah NH. Association Between Androgen Deprivation Therapy and Risk of Dementia. JAMA Oncol. Published online October 13, 2016. doi:10.1001/jamaoncol.2016.3662
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