Correlation of androgen deprivation therapy with cognitive dysfunction in patients with prostate cancer

A nationwide population-based study using the national health insurance service database

Bum Sik Tae, Byung Jo Jeon, Seung Hun Shin, Hoon Choi, Jae Hyun Bae, Jae Young Park

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)593-602
Number of pages10
JournalCancer Research and Treatment
Volume51
Issue number2
DOIs
Publication statusPublished - 2019 Jan 1

Fingerprint

National Health Programs
Androgens
Prostatic Neoplasms
Databases
Population
Therapeutics
Kaplan-Meier Estimate
Cognitive Dysfunction
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Peripheral Vascular Diseases
Survival Analysis
Proportional Hazards Models
Aspirin
Dementia
History
Prospective Studies
Hypertension

Keywords

  • Androgen deprivation therapy
  • Cognitive dysfunction
  • Nationwide population-based study
  • Prostate neoplasm

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

@article{63b2ad16b3454400bdcd259102e53ef4,
title = "Correlation of androgen deprivation therapy with cognitive dysfunction in patients with prostate cancer: A nationwide population-based study using the national health insurance service database",
abstract = "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.",
keywords = "Androgen deprivation therapy, Cognitive dysfunction, Nationwide population-based study, Prostate neoplasm",
author = "Tae, {Bum Sik} and Jeon, {Byung Jo} and Shin, {Seung Hun} and Hoon Choi and Bae, {Jae Hyun} and Park, {Jae Young}",
year = "2019",
month = "1",
day = "1",
doi = "10.4143/crt.2018.119",
language = "English",
volume = "51",
pages = "593--602",
journal = "Cancer Research and Treatment",
issn = "1598-2998",
publisher = "Korean Society for Thoracic and Cardiovascular Surgery",
number = "2",

}

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

PY - 2019/1/1

Y1 - 2019/1/1

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

UR - http://www.scopus.com/inward/citedby.url?scp=85061222240&partnerID=8YFLogxK

U2 - 10.4143/crt.2018.119

DO - 10.4143/crt.2018.119

M3 - Article

VL - 51

SP - 593

EP - 602

JO - Cancer Research and Treatment

JF - Cancer Research and Treatment

SN - 1598-2998

IS - 2

ER -