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Article

Association between Androgen Deprivation Therapy and Risk of Dementia in Men with Prostate Cancer

1
Division of Urology, Department of Surgery, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan 33004, Taiwan
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School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
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Research Department of Practice and Policy, UCL School of Pharmacy, London WC1N 1AX, UK
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Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Department of Pharmacy, Keelung Chang Gung Memorial Hospital, Keelung 20401, Taiwan
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Cancer Research Center, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97002, Taiwan
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College of Medicine, Tzu Chi University, Hualien 97004, Taiwan
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Department of Urology, Keelung Chang Gung Memorial Hospital, Keelung 20401, Taiwan
*
Author to whom correspondence should be addressed.
Academic Editor: Vasiliki Tzelepi
Cancers 2021, 13(15), 3861; https://doi.org/10.3390/cancers13153861
Received: 21 June 2021 / Revised: 26 July 2021 / Accepted: 27 July 2021 / Published: 31 July 2021
(This article belongs to the Special Issue Prostate Cancer: Pathophysiology, Pathology and Therapy)
Androgen deprivation therapy (ADT) is the gold standard treatment for advanced prostate cancer and the subsequent risk of dementia remains controversial. Previous studies were limited by small sample sizes, short follow-up times, and racial differences. In this population-based cohort study, we used the National Health Insurance Database of Taiwan and The Health Improvement Network database of the United Kingdom to retrospectively study 129,126 men with prostate cancer in the United Kingdom (UK) and Taiwan. Compared with the ADT-naïve control, patients treated with ADT showed no significant increase in the risk of dementia in both the UK and Taiwan populations. Despite the differences in the populations of the two databases, these results suggest no association between the use of ADT and new-onset dementia.
The risk of dementia after androgen deprivation therapy (ADT) in patients with advanced prostate cancer (PCa) remains controversial. This study aimed to evaluate the association between ADT and the incidence of dementia in patients with PCa. We identified patients newly diagnosed with PCa in the National Health Insurance Database of Taiwan from 1 January 2002 to 30 June 2016 and in The Health Improvement Network of the United Kingdom (UK) from 1 January 1998 to 31 March 2018. We classified patients with PCa into ADT and ADT-naïve groups. Propensity score (PS) methods were used to minimize the differences in characteristics between the groups. We performed a Cox proportional hazard model to obtain the adjusted hazard ratio (HR) to compare the incidence of dementia between the groups. Our ADT group comprised 8743 and 73,816 patients in Taiwan and the UK, respectively, which were matched 1:1 to ADT-naïve patients by PS. The incidence rates of dementia in the ADT group were 2.74 versus 3.03 per 1000 person-years in the ADT naïve groups in Taiwan, and 2.81 versus 2.79 per 1000 person-years in the UK. There was no statistical difference between ADT and ADT-naïve groups (adjusted HR: 1.12; 95% confidence interval (CI): 0.87–1.43 in Taiwan and adjusted HR: 1.02; 95% CI: 0.85–1.23 in the UK). We found no association between the incidence of dementia and ADT in patients with advanced PCa in either database. Further studies are warranted to evaluate other possible triggers of incident dementia in patients receiving ADT for advanced PCa. View Full-Text
Keywords: androgen deprivation therapy; dementia; prostate cancer; multi-database study androgen deprivation therapy; dementia; prostate cancer; multi-database study
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MDPI and ACS Style

Liu, J.-M.; Shen, C.-Y.; Lau, W.C.Y.; Shao, S.-C.; Man, K.K.C.; Hsu, R.-J.; Wu, C.-T.; Lai, E.C.-C. Association between Androgen Deprivation Therapy and Risk of Dementia in Men with Prostate Cancer. Cancers 2021, 13, 3861. https://doi.org/10.3390/cancers13153861

AMA Style

Liu J-M, Shen C-Y, Lau WCY, Shao S-C, Man KKC, Hsu R-J, Wu C-T, Lai EC-C. Association between Androgen Deprivation Therapy and Risk of Dementia in Men with Prostate Cancer. Cancers. 2021; 13(15):3861. https://doi.org/10.3390/cancers13153861

Chicago/Turabian Style

Liu, Jui-Ming, Chin-Yao Shen, Wallis C.Y. Lau, Shih-Chieh Shao, Kenneth K.C. Man, Ren-Jun Hsu, Chun-Te Wu, and Edward C.-C. Lai 2021. "Association between Androgen Deprivation Therapy and Risk of Dementia in Men with Prostate Cancer" Cancers 13, no. 15: 3861. https://doi.org/10.3390/cancers13153861

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