medwireNews: A population-based study has not replicated the previously reported association between Alzheimer’s dementia and androgen deprivation therapy (ADT), but suggests that the risk for non-Alzheimer’s dementia may be elevated with use of gonadotropin-releasing hormone (GnRH) agonists and orchiectomy.
Over a median follow-up of 4.3 years, the incidence of dementia was identical, at 6%, among 25,967 participants of Prostate Cancer data Base Sweden (PCBaSe) whose disease was managed either with ADT or watchful waiting, and 121,018 matched controls who were free from prostate cancer.
Neither watchful waiting nor use of oral antiandrogens in men with prostate cancer was associated with an increased risk for dementia relative to men without prostate cancer, but treatment with GnRH agonists and orchiectomy significantly raised the dementia risk. This association was primarily driven by an increased risk for non-Alzheimer’s dementia, at hazard ratios (HRs) of 1.24 and 1.79 for GnRH agonists and orchiectomy, respectively.
Additionally, the risk appeared to be significantly higher at 1–2 years and 2–4 years after treatment with GnRH agonists and orchiectomy, but not at earlier or later timepoints.
Writing in BJU International, David Robinson (Ryhov Hospital, Jönköping, Sweden) and co-authors caution that the observed associations could be due to selection bias, and stress the need for future research to elucidate the underlying mechanisms.
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