So let’s start with the conclusions from a new paper that was just published in the Journal of Urology: “Men who receive androgen deprivation therapy for prostate cancer have an increased risk of dementia and/or Alzheimer disease compared to men who do not receive androgen deprivation therapy; this was more pronounced when androgen deprivation therapy was given longer than 12 months.”
There is a lot of information to unpack there.
This new paper does not present new data; instead, it is a meta-analysis of previous studies, several of which we’ve commented on before in this blog. This paper, however, provides a very detailed and critical look at 14 of the best studies to date.
To be clear, although ADT can increase the risk of dementia, that risk is still relatively small. One study, for example, which the authors review, found that dementia was observed in 8% of patients who received continuous ADT but in only 4% of those receiving it as intermittent therapy. So the risk of dementia is small but still large enough that one should be aware of that risk, particularly if they are going to be on ADT long term.
The authors “recommend routine monitoring of cognitive function in patients receiving ADT” and, furthermore, suggest that cognitive status should be assessed for all patients starting on ADT.
The authors don’t go further in making suggestions about how to reduce the risk of cognitive impairment while on ADT. However, as we have noted often, staying physically fit can help avoid cognitive impairment from ADT and from aging in general.
To read the study abstract, see: https://pubmed.ncbi.nlm.nih.gov/32856962/
Sari Motlagh, R., Quhal, F., Mori, K., Miura, N., Aydh, A., Laukhtina, E., ... & Shariat, S. F. (2021). The Risk of New Onset Dementia and/or Alzheimer Disease among Patients with Prostate Cancer Treated with Androgen Deprivation Therapy: A Systematic Review and Meta-Analysis. The Journal of urology, 205(1), 60-67