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Effects of long‐term androgen deprivation therapy on cognitive function over 36 months in men with prostate cancer
Author(s) -
Alibhai Shabbir M.H.,
Timilshirhari,
DuffCanning Sarah,
Breunis Henriette,
Tannock Ian F.,
Naglie Gary,
Fleshner Neil E.,
Krahn Murray D.,
Warde Padraig,
Marzouk Shireen,
Tomlinson George A.
Publication year - 2017
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.30320
Subject(s) - androgen deprivation therapy , medicine , prostate cancer , cognition , neuropsychology , cognitive test , cognitive decline , cancer , dementia , psychiatry , disease
BACKGROUND Many men with prostate cancer (PC) require long‐term androgen deprivation therapy (ADT), but to the authors' knowledge, its effects on cognitive function beyond 1 year are not described. METHODS Three groups of men aged ≥50 years who were matched based on age and education were enrolled: 77 patients with nonmetastatic PC who initiated continuous ADT, 82 patients with PC who were not receiving ADT (PC controls), and 82 healthy controls. A battery of 14 neuropsychological tests, examining 8 cognitive domains, was administered on 5 occasions over 36 months. Changes in cognitive scores over time were analyzed using 3 approaches: linear mixed effects regression, the percentage of participants per group with declines in ≥1/2 cognitive tests, and a global summary of cognitive change. RESULTS The mean age of the study subjects was 68.9 years, with a median of 16 years of education. In mixed effects models adjusted for age and education, ADT use was not found to be associated with significant changes over time in any cognitive test compared with healthy controls. The percentage of participants declining by ≥1.5 standard deviations in ≥2 tests or ≥2 standard deviations in ≥1 tests was similar across groups. A global summary of cognitive change found no statistically significant worsening of cognitive function among ADT users compared with controls. Sensitivity analyses adjusting for duration of ADT and using multiple imputation for missing data did not materially alter the study findings. CONCLUSIONS The ongoing use of ADT for up to 36 months does not appear to be associated with cognitive decline. Cancer 2017;123:237–244. © 2016 American Cancer Society .