School of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC), Barcelona, Spain.
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Psychooncology. 2024 Mar;33(3):e6336. doi: 10.1002/pon.6336.
Androgen deprivation therapy (ADT) is a common treatment for prostate cancer (PCa), with increasing numbers of men on ADT for longer. Limited evidence suggests ADT impacts cognition. This study addressed gaps in the literature by focusing on older men with PCa and assessing ADT usage longer than 1 year.
This study of 133 men ≥65 years of age with PCa included two groups: (1) men on ADT for 1-3 years (ADT-exposed), and (2) a comparison group of men with PCa not on ADT (ADT-unexposed). Group comparisons on individual neuropsychological test scores are reported, as well as effect sizes (Cohen's d).
Half (n = 67) of the sample was ADT-exposed and half (n = 66) were unexposed. The average age was 72 years, most were White, and over 50% had at least secondary education. There were no statistically significant differences between groups by age, race, or education. Unadjusted analyses showed the ADT-exposed group, compared with the ADT-unexposed group, performed significantly lower in domains of verbal learning (d = 0.45-0.52, p = 0.01 to <0.01), verbal recall (d = 0.33-0.54, p = 0.06 to <0.01), and possible effects in visuospatial construction (d = 0.33, p = 0.08 to 0.06). When controlling for age and education, similar patterns emerged. The ADT exposed-group performed significantly lower in domains of verbal learning (d = 0.45-0.52, p = 0.06 to 0.03) and verbal recall (d = 0.33-0.54, p = 0.11 to 0.03), and possible effects in visuospatial construction d = 0.33, p = 0.18 to 0.13.
This study suggests long-term ADT exposure impacts verbal learning, verbal recall, and possibly visuospatial abilities in older men (≥65) with PCa. The potential cognitive effects of ADT should be discussed with older patients considering long-term use of ADT.
去势治疗（ADT）是前列腺癌（PCa）的常见治疗方法，越来越多的男性接受 ADT 治疗时间更长。有限的证据表明 ADT 会影响认知。本研究通过关注年龄较大的患有 PCa 的男性并评估 ADT 使用时间超过 1 年，解决了文献中的空白。
这项针对 133 名年龄≥65 岁患有 PCa 的男性的研究包括两组：（1）接受 ADT 治疗 1-3 年的男性（ADT 暴露组），和（2）一组未接受 ADT 治疗的 PCa 男性（ADT 未暴露组）。报告了个体神经心理学测试分数的组间比较，以及效应大小（Cohen's d）。
样本中有一半（n=67）接受 ADT 治疗，另一半（n=66）未接受 ADT 治疗。平均年龄为 72 岁，大多数为白人，超过 50%的人至少受过中学教育。两组在年龄、种族或教育程度方面无统计学差异。未经调整的分析显示，与 ADT 未暴露组相比，ADT 暴露组在言语学习（d=0.45-0.52，p=0.01 至 <0.01）、言语回忆（d=0.33-0.54，p=0.06 至 <0.01）和可能的视空间建构领域的表现明显较低（d=0.33，p=0.08 至 0.06）。当控制年龄和教育程度时，出现了类似的模式。ADT 暴露组在言语学习（d=0.45-0.52，p=0.06 至 0.03）和言语回忆（d=0.33-0.54，p=0.11 至 0.03）领域以及可能的视空间建构领域的表现明显较低（d=0.33，p=0.18 至 0.13）。
本研究表明，长期 ADT 暴露会影响年龄较大（≥65 岁）患有 PCa 男性的言语学习、言语回忆和可能的视空间能力。应与考虑长期使用 ADT 的老年患者讨论 ADT 的潜在认知影响。
