Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.
Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
J Alzheimers Dis. 2022;89(1):367-380. doi: 10.3233/JAD-220436.
A negative association between cancer and Alzheimer's disease (AD) was revealed.
We aimed to further explore the dementia risk among cancer survivors and then among cancer survivors who received cancer treatment in subsequent subgroup analyses.
Databases of PubMed, Embase, and Cochrane Library were systematically searched from inception to April 1, 2021, following PRISMA and MOOSE guidelines. Relative risks (RR) of dementia were pooled by a random-effects model stratifying the data by potential confounding factors to explore the heterogeneity. This study is registered with PROSPERO, number CRD42021250654.
A total of 36 studies were included in this meta-analysis, of which 16 studies were about the risk of dementia in cancer survivors, and 20 studies were about the risk of dementia in survivors who accepted cancer treatment. The pooled RR reached 0.89 ([95% CI = 0.82-0.97], I2 = 97.9%) for dementia and 0.89 ([0.83-0.95], I2 = 92.6%) for AD in cancer survivors compared with non-cancer controls. Notably, both dementia risk and AD risk significantly decreased in survivors of colon, leukemia, small intestine, and thyroid cancers (RR ranged from 0.64 to 0.92). Furthermore, prostate cancer patients treated with androgen deprivation therapy exhibited a significantly increased risk of dementia (RR:1.18 [1.09-1.27], I2 = 89.5%) and AD (RR:1.17 [1.08-1.25], I2 = 81.3%), with evidence of between-study heterogeneity.
Currently, available evidence suggests that the risk of dementia among cancer survivors is decreased. However, large-scale prospective cohort studies are warranted to further prove the association.
癌症与阿尔茨海默病（AD）之间呈负相关。
我们旨在进一步探讨癌症幸存者的痴呆风险，然后在随后的亚组分析中探讨接受癌症治疗的癌症幸存者的痴呆风险。
根据 PRISMA 和 MOOSE 指南，系统地检索了 PubMed、Embase 和 Cochrane Library 数据库，检索时间截至 2021 年 4 月 1 日。通过随机效应模型对数据进行分层，以潜在混杂因素为基础，合并痴呆风险的相对风险（RR），以探索异质性。本研究已在 PROSPERO 注册，编号 CRD42021250654。
本荟萃分析共纳入 36 项研究，其中 16 项研究探讨了癌症幸存者痴呆风险，20 项研究探讨了接受癌症治疗的幸存者痴呆风险。与非癌症对照组相比，痴呆风险和 AD 风险的合并 RR 分别为 0.89（95%CI=0.82-0.97，I2=97.9%）和 0.89（0.83-0.95，I2=92.6%）。值得注意的是，结直肠癌、白血病、小肠癌和甲状腺癌幸存者的痴呆风险和 AD 风险均显著降低（RR 范围为 0.64-0.92）。此外，接受雄激素剥夺治疗的前列腺癌患者痴呆风险显著增加（RR：1.18 [1.09-1.27]，I2=89.5%）和 AD 风险（RR：1.17 [1.08-1.25]，I2=81.3%），存在研究间异质性。
目前，现有证据表明癌症幸存者痴呆风险降低。但是，需要开展大规模前瞻性队列研究来进一步证实这种关联。
