Kao Li-Ting, Lin Herng-Ching, Chung Shiu-Dong, Huang Chao-Yuan
Graduate Institute of Life Science, National Defense Medical Center, Taipei 110, Taiwan, China.
Sleep Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan, China.
Asian J Androl. 2017 Jul-Aug;19(4):414-417. doi: 10.4103/1008-682X.179528.
Prior studies suggested that the use of androgen deprivation therapy (ADT) in patients with prostate cancer (PC) might cause the impairment of cognitive function which is one of the common symptoms of dementia; however, the association between ADT and cognitive impairment still remains controversial. This retrospective cohort study aimed to investigate the relationship between ADT and subsequent risk of dementia using a population-based dataset. Data for this study were taken from the Taiwan (China)Longitudinal Health Insurance Database 2005. We included 755 PC patients who received ADT in the study cohort and 559 PC patients who did not receive ADT in the comparison cohort. Each patient was individually tracked for a 5-year period to define those who subsequently received a diagnosis of dementia. Results show that the incidence rates of dementia per 100 person-years were 2.35 (95% confidence interval [95% CI]: 1.82-2.98) and 1.85 (95% CI: 1.35-2.48) for PC patients who received ADT and those who did not receive ADT, respectively. The adjusted hazard ratio (HR) for dementia for PC patients who received ADT was 1.21 (95% CI: 0.82-1.78, P = 0.333) compared to those who did not receive ADT. In addition, the adjusted HRs for dementia for PC patients receiving ADT with gonadotropin-releasing hormone (GnRH) agonists and without GnRH agonists were 1.39 (95% CI: 0.80-2.40, P = 0.240) and 1.13 (95% CI: 0.75-1.71, P = 0.564), respectively, compared to PC patients not receiving ADT. We concluded that there was no difference in the risk of subsequent dementia between PC patients who did and those who did not receive ADT.
先前的研究表明,在前列腺癌(PC)患者中使用雄激素剥夺疗法(ADT)可能会导致认知功能受损,而认知功能受损是痴呆症的常见症状之一;然而,ADT与认知障碍之间的关联仍存在争议。这项回顾性队列研究旨在使用基于人群的数据集调查ADT与随后患痴呆症风险之间的关系。本研究的数据取自2005年中国台湾地区纵向健康保险数据库。我们将755例接受ADT的PC患者纳入研究队列,将559例未接受ADT的PC患者纳入对照队列。对每位患者进行为期5年的个体跟踪,以确定那些随后被诊断为痴呆症的患者。结果显示,接受ADT和未接受ADT的PC患者每100人年的痴呆症发病率分别为2.35(95%置信区间[95%CI]:1.82 - 2.98)和1.85(95%CI:1.35 - 2.48)。与未接受ADT的PC患者相比,接受ADT的PC患者患痴呆症的调整后风险比(HR)为1.21(95%CI:0.82 - 1.78,P = 0.333)。此外,与未接受ADT的PC患者相比,接受促性腺激素释放激素(GnRH)激动剂和未接受GnRH激动剂的ADT治疗的PC患者患痴呆症的调整后HR分别为1.39(95%CI:0.80 - 2.40,P = 0.240)和1.13(95%CI:0.75 - 1.71,P = 0.564)。我们得出结论,接受和未接受ADT的PC患者随后患痴呆症的风险没有差异。