Cognitive decline in prostate cancer patients undergoing ADT: a potential role for exercise training

Abstract

Androgen deprivation therapy (ADT) is an effective and widely prescribed treatment for prostate cancer (PCa), but it is associated with multiple treatment-induced adverse effects that impact on various musculoskeletal and cardiometabolic health outcomes. Emerging research has shown that ADT is also associated with cognitive impairment, which has been linked to a loss of independence, increased falls and fracture risk and greater use of medical services. The aim of this review is to outline the evidence related to the effect of ADT use on cognitive function, and propose a role for exercise training as part of usual care to prevent and/or manage cognitive impairments for PCa survivors on ADT. The following results have been obtained from this study. ADT has been shown to adversely affect specific cognitive domains, particularly verbal memory, visuomotor function, attention and executive function. However, current clinical guidelines do not recommend routine assessment of cognitive function in these men. No studies have examined whether exercise training can preserve or improve cognitive function in these men, but in healthy adults', multimodal exercise training incorporating aerobic training, progressive resistance training (PRT) and challenging motor control exercises have the potential to attenuate cognitive decline. In conclusion, as treatment with ADT for men with PCa has been associated with a decline in cognition, it is recommended that cognitive function be routinely monitored in these men and that regular exercise training be prescribed to preserve (or improve) cognitive function. Assessment of cognition and individualised exercise training should be considered in the usual treatment plan of PCa patients receiving ADT.

Influence of symptoms of depression on the quality of life of men diagnosed with prostate cancer

“…It has been found that in the treatment period of the disease there are consequences for the physical health of the patient, such as fatigue, insomnia, nausea and vomiting, pain, dyspnea, constipation, diarrhea, urinary and intestinal symptoms and urinary incontinence 8,9 . In the present study, the symptomatic scale of both the general and specific questionnaire for men with prostate cancer revealed that worst results were related to the presence of depressive symptoms.…”

“…Among the modalities of treatment for prostate cancer, radical prostatectomy, in which the patient undergoes complete removal of the prostate, is the oldest and possibly the most effective 7 . Such a method can cause several side effects, such as urethral stenosis, urinary incontinence, erectile dysfunction 5 , fatigue, general distress, functional disability and depression 8,9 , factors that can significantly affect the quality of life of such men 5 .…”

Efficacy of a multi-component exercise programme and nutritional supplementation on musculoskeletal health in men treated with androgen deprivation therapy for prostate cancer (IMPACT): study protocol of a randomised controlled trial

“…Previous research has shown that ADT use is associated with cognitive decline, particularly in the domains of verbal memory, visuomotor function, attention and executive function [ 80 ]. Thus, this study will include a number of established and valid cognitive tests to assess the different cognitive domains.…”

No increased risk of psoriasis in patients receiving androgen deprivation therapy for prostate cancer: a 17-year population-based study

“… 2 However, long-term deprivation of androgen may cause some systemic adverse effects, such as metabolic complications and cardiovascular disease. 3 – 7 Alterations to the immune system in patients with ADT were also noted. 8 , 9 Increased risk of rheumatoid arthritis in patients with ADT has also been observed.…”