First, do no harm? Study finds association between androgen deprivation therapy and increased risk of Alzheimer’s disease

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prostate_cancer_therapyPros­trate Can­cer Treat­ment Tied To Alzheimer’s Risk (New York Times):

“Hor­mone ther­a­py, a com­mon treat­ment for prostate can­cer, is asso­ci­at­ed with an increased risk for Alzheimer’s dis­ease, a new study has found…Overall, those treat­ed with hor­mone ther­a­py had an 88 per­cent increased risk of Alzheimer’s com­pared with oth­er patients. The longer the hor­mone treat­ment, the more the risk increased, and patients with at least 12 months of treat­ment had more than dou­ble the risk.”

Study: Andro­gen Depri­va­tion Ther­a­py and Future Alzheimer’s Dis­ease Risk (Jour­nal of Clin­i­cal Oncol­o­gy). From the abstract:

  • Pur­pose: To test the asso­ci­a­tion of andro­gen depri­va­tion ther­a­py (ADT) in the treat­ment of prostate can­cer with sub­se­quent Alzheimer’s dis­ease risk.
  • Meth­ods: We used a pre­vi­ous­ly val­i­dat­ed and imple­ment­ed text-pro­cess­ing pipeline to ana­lyze elec­tron­ic med­ical record data in a ret­ro­spec­tive cohort of patients at Stan­ford Uni­ver­si­ty and Mt. Sinai hospitals.…We then test­ed the effect of ADT on risk of Alzheimer’s disease…
  • Results: There were 16,888 indi­vid­u­als with prostate can­cer meet­ing all inclu­sion and exclu­sion cri­te­ria, with 2,397 (14.2%) receiv­ing ADT…Propensity score and tra­di­tion­al mul­ti­vari­able-adjust­ed Cox regres­sion analy­sis both sup­port­ed a sta­tis­ti­cal­ly sig­nif­i­cant asso­ci­a­tion between ADT use and Alzheimer’s dis­ease risk. We also observed a sta­tis­ti­cal­ly sig­nif­i­cant increased risk of Alzheimer’s dis­ease with increas­ing dura­tion of ADT (P = .016).
  • Con­clu­sion: Our results sup­port an asso­ci­a­tion between the use of ADT in the treat­ment of prostate can­cer and an increased risk of Alzheimer’s dis­ease in a gen­er­al pop­u­la­tion cohort. This study demon­strates the util­i­ty of nov­el meth­ods to ana­lyze elec­tron­ic med­ical record data to gen­er­ate prac­tice-based evidence.

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