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 / Journal of the Korean Cancer Association, 대한암학회지
Cancer Research and Treatment
;
: 593-602, 2019.
Article
in English
| WPRIM
| ID: wpr-763135
ABSTRACT
PURPOSE:
The purpose of this study was to evaluate the association of androgen deprivation therapy (ADT) with cognitive dysfunction. MATERIALS ANDMETHODS:
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Prostate
/
Prostatic Neoplasms
/
Aspirin
/
Prospective Studies
/
Cohort Studies
/
Follow-Up Studies
/
Peripheral Vascular Diseases
/
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/
Dementia
/
Kaplan-Meier Estimate
Type of study:
Etiology study
/
Incidence study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adult
/
Humans
/
Male
Language:
English
Journal:
Cancer Research and Treatment
Year:
2019
Type:
Article
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