Analysis of Brain Functions in Men with Prostate Cancer under Androgen Deprivation Therapy: A One-Year Longitudinal Study

Abstract

The relationship between cognitive decline and androgen deprivation therapy (ADT) under luteinizing hormone-releasing hormone (LHRH) analogues is unclear, and there is a scarcity of longitudinal studies considering the interaction between cognition, depressive symptoms and sleep quality in men with prostate cancer (PCa) treated with ADT. This study aimed to determine if there were differences in the scores obtained in cognitive assessment, depressive symptoms, and sleep quality after one year of ADT and determine the interrelations between sleep, mood, and cognitive status. A prospective longitudinal observational study was designed, in which a cohort of men (mean age was 70.8 years) newly treated with androgen-deprivation therapy was assessed in the first six months of treatment and 12 months later. Analysis of cognitive function by the Mini-Mental State Examination (MMSE) scores indicated a significant (p < 0.05) increase after one year of treatment and by the Brief Scale for Cognitive Evaluation (BCog) scores indicated no changes in the scores before and after one year of treatment. Analysis of depressive symptoms with the Geriatric Depression Scale and sleep quality with the Athens Insomnia Scale (AIS) scores showed significant (p < 0.05) changes after one year of treatment with ADT, with men describing more depressive symptoms and more sleep disturbances. No statistically significant differences were found in the cognitive performance between men with impaired sleep or depression results and those without them. Our study showed no clinical evidence of the relationship between ADT under luteinizing hormone-releasing hormone (LHRH) analogues and cognitive deterioration in 1-year follow-up, but there are impairments in the sleep quality in men with PCa undergoing ADT and an increase in depressive symptoms which has important implications for clinicians as they would impair quality of life and adherence to treatment.

Prostate Cancer and Sleep Disorders: A Systematic Review

“…Finally, Sánchez-Martínez et al demonstrated in 33 subjects worse sleep quality, as measured by Athens Insomnia Scale (AIS), after 1 year of follow-up (first evaluation within six months to one year of ADT) [ 63 ]. All these studies suggest that ADT may play a fundamental role in the onset of sleep disorders in patients with prostate cancer.…”

Reliability of Frail and Barthel Tests for Detecting Frailty in Palliative Oncological Patients in a Home Hospitalization Unit: A Comparative Study

“…A palliative care nurse (SLR) performed a cognitive function assessment to establish the participant's cognitive eligibility. This was performed according to Mini-Mental State Examination (MMSE) for analysis of cognitive function [20]. The MMSE is a quick and easy measure that assesses seven areas of cognitive functioning, and it was shown to have both good test-retest reliability (0.80-0.95) [21] and acceptable sensitivity and specificity to detect mild to moderate stages of dementia [22].…”

Development of depression in patients using androgen deprivation therapy: A systemic review and meta‐analysis

“…The search and study selection procedure are summarized in the PRISMA flow chart (Figure 1). We identified 38 studies out of which 17 were retrospective studies, 4,7,9,10,[20][21][22][23][24][25][26][27][28][29][30][31][32] 16 prospective studies, 6,11,13,[33][34][35][36][37][38][39][40][41][42][43][44][45] 2 cross-sectional 46,47 and two randomized trials. 48,49 A total of 360,650 patients were included in the study.…”

“…The Hospital Anxiety and Depression Scales (HADS) was utilized by seven studies. 6,9,12,20,34,43,46 The Geriatric Depression Scale was employed by two studies. 21,31 The Beck Depression Inventory (BDI) scale was used in four studies.…”