Androgen deprivation therapy increases risk of dementia
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Androgen deprivation therapy increases risk of dementia Androgen deprivation therapy (ADT) in patients with prostate cancer appears to increase the risk of dementia, according to findings of a systematic review and meta-analysis published in the Journal of Urology. PubMed and Web of Science databases were searched up to January 2020 for studies reporting the incidence of dementia and/or and Alzheimer’s disease (AD) in patients with prostate cancer who received ADT (gonadotropinreleasing hormone stimulants, LHRH receptor agonists or LHRH receptor antagonists) compared with those who did not receive ADT. Six meta-analyses were performed to assessed the associations between ADT for up to 12 months or over 12 months and all-cause dementia (including AD), AD, and AD or all-cause dementia. Of the 14 studies which met the selection criteria, nine reported data onb all-cause dementia, eight reported data on AD, and five assessed the risks based on the duration of ADT. The risk of all-cause dementia and AD was higher in patients who received ADT (hazard ratio [(HR] 1.21; 95% CI 1.11, 1.33) than in those who received no ADT (HR 1.16; 95% CI 1.09, 1.24). The risk of all-cause dementia was significantly increased in patients who received ADT for over 12 months (HR 1.36; 95% CI 1.07, 1.72) but not in those who received ADT for less than 12 months (HR 1.06; 95% CI 0.77, 1.28). No association was found between the duration of ADT and the risk of AD. "Based on these findings, we recommend routine monitoring of cognitive function in patients receiving ADT as well as mental/cognitive status assessment should be performed in all patients planned for ADT. Adequate patient counselling about these potential side effects of ADT should be part of the decision-making and follow up strategy," said the authors. Sari Motlagh R, et al. The Risk of New Onset Dementia And/Or Alzheimer’s Disease Among Prostate Cancer Patients Treated with Androgen Deprivation Therapy: A 803500772 Systematic Review and Meta-analysis. Journal of Urology : 28 Aug 2020. Available from: URL: http://doi.org/10.1097/JU.0000000000001341
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Reactions 12 Sep 2020 No. 1821
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