Jeon Ha-Lim, Choo Eunjung, Jeong Seung-Hwan, Yun Jiwoo, Jeong Chang Wook, Lee Hankil
School of Pharmacy and Institute of New Drug Development, Jeonbuk National University, Jeonju, Jeonbuk, Republic of Korea.
Department of Clinical Pharmacy, School of Pharmacy, Ajou University, Suwon, Republic of Korea.
Sci Rep. 2025 Jul 2;15(1):23490. doi: 10.1038/s41598-025-08279-6.
The association between androgen deprivation therapy (ADT) and dementia including Alzheimer's disease remains debatable. Moreover, the evidence regarding the risk of vascular dementia and Parkinson's disease associated with ADT is limited. A population-based cohort study was conducted using the national health insurance data (2012-2022) from South Korea. Eligible patients newly diagnosed with prostate cancer who underwent ADT were compared with those who did not receive ADT. We applied propensity score matching and performed Cox proportional hazards regression analysis to calculate the adjusted hazard ratios (aHR) and 95% confidence intervals (CI). Of 163,723 patients with prostate cancer between 2013 and 2017, 24,456 were eligible. After 1:1 propensity score matching, 10,168 patients were included in each group. The risk of overall dementia was not significantly higher in ADT users compared with that of non-users (aHR = 1.07; 95% CI: 0.97-1.19); however, the elevated risk of Alzheimer's disease was observed (aHR = 1.39; 95% CI: 1.21-1.59). ADT was not associated with the risk of vascular dementia (aHR = 1.14; 95% CI: 0.70-1.94) and Parkinson's disease (aHR = 1.01; 95% CI: 0.75-1.35). Our updated evidence reinforces previous findings, indicating a positive association between ADT and the risk of Alzheimer's disease. However, it is unlikely that ADT increases the risk of vascular dementia and Parkinson's disease.
雄激素剥夺疗法（ADT）与包括阿尔茨海默病在内的痴呆症之间的关联仍存在争议。此外，关于ADT与血管性痴呆和帕金森病风险相关的证据有限。我们利用韩国的国民健康保险数据（2012 - 2022年）进行了一项基于人群的队列研究。将新诊断为前列腺癌并接受ADT的符合条件患者与未接受ADT的患者进行比较。我们应用倾向评分匹配并进行Cox比例风险回归分析，以计算调整后的风险比（aHR）和95%置信区间（CI）。在2013年至2017年的163723例前列腺癌患者中，24456例符合条件。经过1:1倾向评分匹配后，每组纳入10168例患者。与未使用ADT的患者相比，ADT使用者的总体痴呆风险没有显著升高（aHR = 1.07；95% CI：0.97 - 1.19）；然而，观察到阿尔茨海默病风险升高（aHR = 1.39；95% CI：1.21 - 1.59）。ADT与血管性痴呆风险（aHR = 1.14；95% CI：0.70 - 1.94）和帕金森病风险（aHR = 1.01；95% CI：0.75 - 1.35）无关。我们更新后的证据强化了先前的研究结果，表明ADT与阿尔茨海默病风险之间存在正相关。然而，ADT不太可能增加血管性痴呆和帕金森病的风险。
