TY - JOUR
T1 - Correlation of androgen deprivation therapy with cognitive dysfunction in patients with prostate cancer
T2 - A nationwide population-based study using the national health insurance service database
AU - Tae, Bum Sik
AU - Jeon, Byung Jo
AU - Shin, Seung Hun
AU - Choi, Hoon
AU - Bae, Jae Hyun
AU - Park, Jae Young
N1 - Funding Information:
This research was supported by a Korea University Grant and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (2017R1A2B4005876).
Publisher Copyright:
Copyright © 2019 by the Korean Cancer Association.
PY - 2019
Y1 - 2019
N2 - Purpose The purpose of this study was to evaluate the association of androgen deprivation therapy (ADT) with cognitive dysfunction. Materials and Methods Using the National Health Insurance Service database of the entire Korean adult prostate cancer population (n=236,391), data on ADT and cognitive dysfunction between 2008 and 2015 were analyzed. We excluded patients previously diagnosed with cognitive dysfunction, dementia, or a cerebral event history. We tested the effect of ADT on the risk of cognitive dysfunction using propensity score–matched Cox proportional hazards regression models and Kaplan-Meier survival analysis. Our final cohort comprised of 35,401 individuals with prostate cancer, including 24,567 men (70.6%) who underwent ADT. Results During a mean follow-up period of 4.1 years, 4,741 patients were newly diagnosed with cognitive dysfunction. A statistically significant association was found between ADT and the risk of cognitive dysfunction (hazard ratio, 1.169; p=0.002). Meanwhile, age (≥ 70 years), diabetes, hypertension, cardiovascular history, and peripheral vascular disease were identified as factors that contribute to the increased risk of cognitive dysfunction. In contrast, the use of statins and aspirin was associated with a lower risk of cognitive dysfunction. Kaplan-Meier analysis demonstrated that patients aged 70 years or older who underwent ADT had the lowest cumulative probability of remaining cognitive dysfunction-free (log-rank p < 0.001). Conclusion Our results revealed an association between the use of ADT for the treatment of prostate cancer and an increased risk of cognitive dysfunction in a nationwide population-based study. This finding should be further evaluated in prospective studies.
AB - Purpose The purpose of this study was to evaluate the association of androgen deprivation therapy (ADT) with cognitive dysfunction. Materials and Methods Using the National Health Insurance Service database of the entire Korean adult prostate cancer population (n=236,391), data on ADT and cognitive dysfunction between 2008 and 2015 were analyzed. We excluded patients previously diagnosed with cognitive dysfunction, dementia, or a cerebral event history. We tested the effect of ADT on the risk of cognitive dysfunction using propensity score–matched Cox proportional hazards regression models and Kaplan-Meier survival analysis. Our final cohort comprised of 35,401 individuals with prostate cancer, including 24,567 men (70.6%) who underwent ADT. Results During a mean follow-up period of 4.1 years, 4,741 patients were newly diagnosed with cognitive dysfunction. A statistically significant association was found between ADT and the risk of cognitive dysfunction (hazard ratio, 1.169; p=0.002). Meanwhile, age (≥ 70 years), diabetes, hypertension, cardiovascular history, and peripheral vascular disease were identified as factors that contribute to the increased risk of cognitive dysfunction. In contrast, the use of statins and aspirin was associated with a lower risk of cognitive dysfunction. Kaplan-Meier analysis demonstrated that patients aged 70 years or older who underwent ADT had the lowest cumulative probability of remaining cognitive dysfunction-free (log-rank p < 0.001). Conclusion Our results revealed an association between the use of ADT for the treatment of prostate cancer and an increased risk of cognitive dysfunction in a nationwide population-based study. This finding should be further evaluated in prospective studies.
KW - Androgen deprivation therapy
KW - Cognitive dysfunction
KW - Nationwide population-based study
KW - Prostate neoplasm
UR - http://www.scopus.com/inward/record.url?scp=85061222240&partnerID=8YFLogxK
U2 - 10.4143/crt.2018.119
DO - 10.4143/crt.2018.119
M3 - Article
C2 - 30025445
AN - SCOPUS:85061222240
SN - 1598-2998
VL - 51
SP - 593
EP - 602
JO - Cancer Research and Treatment
JF - Cancer Research and Treatment
IS - 2
ER -