MedicalResearch.com Interview with:
Kevin T. Nead, MD, MPhil
Dept. of Radiation Oncology
Perelman School of Medicine
University of Pennsylvania
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Nead: There are a growing number of studies suggesting that the use of Androgen Deprivation Therapy (ADT) may be associated with cognitive changes and some of these changes overlap with characteristic features of Alzheimer’s disease. In addition, low testosterone levels have been associated with Alzheimer’s disease risk and ADT lowers testosterone levels. Despite these findings, we could not identify any studies examining the association between ADT and Alzheimer’s disease risk. We therefore felt this study could make an important contribution in guiding future research to fully understand the relative risks and benefits of ADT.
We examined electronic medical record data from Stanford University and Mt. Sinai hospitals to identify a cohort of 16,888 patients with prostate cancer. We found that men with prostate cancer who received Androgen Deprivation Therapy were more likely to develop Alzheimer’s disease than men who did not receive Androgen Deprivation Therapy. We also found that this risk increased with a longer duration of ADT. These results were consistent using multiple statistical approaches and separately at both Stanford and Mr. Sinai.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Nead: Multiple studies suggest that Androgen Deprivation Therapy may be associated with cognitive changes. The current study supports the association between ADT and cognitive changes and reinforces the need for further evaluation of this association in prospective studies. We would not recommend changes to clinical practice based on this study alone given that Androgen Deprivation Therapy is a life extending treatment in some patients with prostate cancer.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Nead: These findings need to be replicated in other datasets. Ultimately, prospective studies are needed to evaluate evidence for causality between Androgen Deprivation Therapy and Alzheimer’s disease. Future studies should also attempt to clarify which individuals are at greatest risk, such as older patients or those with greater comorbidity, and whether this association differs by type of androgen deprivation therapy.
Kevin T. Nead, Greg Gaskin, Cariad Chester, Samuel Swisher-McClure, Nicholas J. Leeper, and Nigam H. Shah. Androgen Deprivation Therapy and Future Alzheimer’s Disease Risk. Journal of Clinical Oncology, December 2015 DOI: 1200/JCO.2015.63.6266