Course and Predictors of Cognitive Function in Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Controlled Comparison
- PMID: 25964245
- PMCID: PMC4461804
- DOI: 10.1200/JCO.2014.60.1963
Course and Predictors of Cognitive Function in Patients With Prostate Cancer Receiving Androgen-Deprivation Therapy: A Controlled Comparison
Abstract
Purpose: Men receiving androgen-deprivation therapy (ADT) for prostate cancer may be at risk for cognitive impairment; however, evidence is mixed in the existing literature. Our study examined the impact of ADT on impaired cognitive performance and explored potential demographic and genetic predictors of impaired performance.
Patients and methods: Patients with prostate cancer were assessed before or within 21 days of starting ADT (n = 58) and 6 and 12 months later. Age- and education-matched patients with prostate cancer treated with prostatectomy only (n = 84) and men without prostate cancer (n = 88) were assessed at similar intervals. Participants provided baseline blood samples for genotyping. Mean-level cognitive performance was compared using mixed models; cognitive impairment was compared using generalized estimating equations.
Results: ADT recipients demonstrated higher rates of impaired cognitive performance over time relative to all controls (P = .01). Groups did not differ at baseline (P > .05); however, ADT recipients were more likely to demonstrate impaired performance within 6 and 12 months (P for both comparisons < .05). Baseline age, cognitive reserve, depressive symptoms, fatigue, and hot flash interference did not moderate the impact of ADT on impaired cognitive performance (P for all comparisons ≥ .09). In exploratory genetic analyses, GNB3 single-nucleotide polymorphism rs1047776 was associated with increased rates of impaired performance over time in the ADT group (P < .001).
Conclusion: Men treated with ADT were more likely to demonstrate impaired cognitive performance within 6 months after starting ADT relative to matched controls and to continue to do so within 12 months after starting ADT. If confirmed, findings may have implications for patient education regarding the risks and benefits of ADT.
© 2015 by American Society of Clinical Oncology.
Conflict of interest statement
Authors' disclosures of potential conflicts of interest are found in the article online at
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Comment in
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Prostate cancer: Treatment with ADT impairs cognitive performance.Nat Rev Urol. 2015 Jul;12(7):361. doi: 10.1038/nrurol.2015.126. Epub 2015 May 26. Nat Rev Urol. 2015. PMID: 26032541 No abstract available.
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Patients Who Receive Androgen Deprivation Therapy Risk Adverse Cognitive Changes.J Clin Oncol. 2015 Dec 20;33(36):4314-5. doi: 10.1200/JCO.2015.63.5698. Epub 2015 Oct 26. J Clin Oncol. 2015. PMID: 26503208 No abstract available.
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Re: Course and Predictors of Cognitive Function in Patients with Prostate Cancer Receiving Androgen-Deprivation Therapy: A Controlled Comparison.J Urol. 2016 Jan;195(1):97. doi: 10.1016/j.juro.2015.10.038. Epub 2015 Nov 19. J Urol. 2016. PMID: 26699965 No abstract available.
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