Hormone therapy for prostate cancer increases the risk of Alzheimer’s disease: a nationwide 4-year longitudinal cohort study

Jhan, Jhen‐Hao; Yang, Yuan‐Han; Chang, Yo-Chen; Guu, Shiao-Jin; Tsai, Chia‐Chun

doi:10.1080/13685538.2016.1271782

Cited by 36 publications

(27 citation statements)

References 28 publications

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“…Alzheimer’s disease (AD), the fifth leading cause of death in adults over 65 years of age in the United States, is one of the most prevalent neurodegenerative disorders worldwide [ 1 ]. In the United States, an estimated 5.2 million individuals over 65 years of age had AD in 2012 [ 2 ], and the number of people who develop AD is expected to increase by almost triple, to 13.5 million by 2050 [ 3 , 4 ]. AD and cancer are increasingly prevalent with advancing age, and the probability of the co-occurrence of both AD and cancer in the same patient also rises with increasing age [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Alzheimer’s disease is associated with prostate cancer: a population-based study

et al. 2018

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Alzheimer’s disease and cancer are increasingly prevalent with advancing age. However, the association between Alzheimer’s disease and prostate cancer remains unclear. The aim of this study was to examine the relationship between prior Alzheimer’s disease and subsequent prostate cancer using a population-based dataset in Taiwan. Data for this study were sourced from the Taiwan Longitudinal Health Insurance Database 2005. This case-control study included 2101 prostate cancer patients as cases and 6303 matched controls. We used conditional logistic regression analyses to calculate the odds ratio (OR) and corresponding 95% confidence interval (CI) for Alzheimer’s disease between prostate cancer patients and controls. We found that of the 8404 sampled patients, 128 (1.5%) had been diagnosed with Alzheimer’s disease prior to the index date. A Chi-squared test showed that there was a significant difference in the prevalences of prior Alzheimer’s disease between prostate cancer patients and controls (2.1% vs. 1.3%, p < 0.001). The conditional logistic regression analysis showed that the OR of prior Alzheimer’s disease for prostate cancer patients was 1.53 (95% CI: 1.06∼2.21) compared to controls. Furthermore, the OR of prior Alzheimer’s disease for prostate cancer patients was 1.52 (95% CI: 1.04∼2.22) compared to controls after adjusting for hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, prostatitis, gonorrhea or chlamydia infection, testitis or epididymitis, and alcohol abuse/alcohol dependency syndrome. This study revealed an association between prior Alzheimer’s disease and prostate cancer. We suggest that clinicians be alert to the increased risk of prostate cancer when caring for elderly individuals with Alzheimer’s disease.

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Section: Introductionmentioning

confidence: 99%

Alzheimer’s disease is associated with prostate cancer: a population-based study

et al. 2018

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“…Only three clinical studies have investigated this issue [ 16 , 19 , 20 ] and they were all observational studies. Discrepancy in the incidence of AD (and associated HRs) has been reported in the literature regarding subsequent dementia and AD following ADT for PCa [ 17 , 18 , 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…We found that lag time was a significant moderator of crude HR in our study, which implies that the lag period selected could affect the HR. Khosrow-Khavar and others [ 19 – 21 ] set specific lag times. In the case of Khosrow-Khavar et al [ 19 ], a fixed lag period of a year was set and the implementation of time-dependent exposure.…”

Section: Discussionmentioning

confidence: 99%

“…In the case of Khosrow-Khavar et al [ 19 ], a fixed lag period of a year was set and the implementation of time-dependent exposure. By using this method [ 19 – 21 ], misclassification and immortal bias may have been avoided. However, further bias could result from the adoption of a fixed lag period based on biological knowledge or expert opinion, which could lead to a null hypothesis.…”

Section: Discussionmentioning

confidence: 99%

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Discrepancies on the association between androgen deprivation therapy for prostate cancer and subsequent dementia: meta-analysis and meta-regression

et al. 2017

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Limited literature exists on the association between androgen deprivation therapy (ADT) for prostate cancer (PCa) and subsequent dementia and the study conclusions are in conflicts with one another. We searched several cohort databases from 1960 to 2017 for observational or prospective studies that reported on an association between ADT for PCa and subsequent dementia. A meta-analysis was performed to cumulatively determine the association between ADT and dementia including Alzheimer's disease using an incidence rate ratio (IRR), crude hazard ratio (HR), and adjusted HR. Seven studies were eligible for the meta-analysis, with the inclusion of a total of 90, 543 prostate cancer patients. The pooled overall IRR, crude HR, and adjusted HR were 1.78 [95% confidence interval (CI): 1.51–2.10)], 1.80 (95% CI: 1.05–3.10), and 1.59 (95% CI: 1.16–2.18), respectively. A meta-regression analysis showed that the crude HR was affected by both follow -up duration and lag time in the univariate model (p = < 0.001). However, IRR and adjusted HR were not affected by these moderators. The overall outcomes of IRR, crude HR, and adjusted HR were found to be balanced in the sensitivity analysis. A positive association was demonstrated between ADT and the subsequent incidence of dementia in this meta-analysis. Methodological difference including follow-up duration and the time lag could be related with the discrepancies.

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“… 12 However, there is increasing evidence that hormonal therapy, which is included more often than not in breast cancer treatment (with or without chemotherapy), also has important effects on brain functioning. 13-17 While the literature on the long-term cognitive effects of hormonal therapy is quite sparse compared to that of chemotherapy, the studies that have investigated this question have reported a negative influence of hormonal therapy on cognition in breast cancer patients. 18-20 It has been shown that hormonal therapy can lead to organizational, activational, neurotropic, and neuroprotective deficits in breast cancer survivors.…”

Section: Introductionmentioning

confidence: 99%

Cancer-related cognitive impairment in breast cancer survivors: An examination of conceptual and statistical cognitive domains using principal component analysis

Lambert¹,

Ouimet²,

Wan³

et al. 2018

Oncol Rev

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There is a great deal of variability in the composition of neuropsychological test batteries used in the assessment of cancerrelated cognitive impairment (CRCI). Not only the development of a gold standard approach for CRCI assessment would allow for easier identification of women suffering from CRCI but it would also promote optimal care for survivors. As a first step towards the development of a valid and reliable unified test battery, the objective of this study was to verify whether the theoretical domains commonly used in CRCI assessment are statistically supported, before and after breast cancer treatment. Principal component analyses (PCA) were performed on the results from 23 neuropsychological tests grouped into eight conceptual domains. For baseline data, the Kaiser-Meyer-Olkin was .82 and Bartlett’s X2(253, N=95) = 949.48, P<0.001. A five-component solution explained 60.94% of the common variance. For the post-treatment data, the Kaiser-Meyer-Olkin was .83 and Bartlett’s X2(253, N=95) = 1007.21, P<0.001 and a five component solution explained 62.03% of the common variance. Although a visual comparison of the theoretical model with those determined via PCA indicated important overlap between conceptual domains and statistical components, significant dissimilarities were also observed.

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Hormone therapy for prostate cancer increases the risk of Alzheimer’s disease: a nationwide 4-year longitudinal cohort study

Abstract: The present results suggest that ADT use is associated with an increased risk of developing AD.

Cited by 36 publications

References 28 publications

Alzheimer’s disease is associated with prostate cancer: a population-based study

Alzheimer’s disease is associated with prostate cancer: a population-based study

Discrepancies on the association between androgen deprivation therapy for prostate cancer and subsequent dementia: meta-analysis and meta-regression

Cancer-related cognitive impairment in breast cancer survivors: An examination of conceptual and statistical cognitive domains using principal component analysis

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