Falls in men on androgen deprivation therapy for prostate cancer

Abstract

Abstract Objective Androgen deprivation therapy (ADT) is a common treatment for prostate cancer (PC). However, it may increase the risk of falls due to decreases in testosterone, lean body mass and strength. Falls are a leading cause of morbidity and mortality in older adults. However, the impact of ADT on falls remains unclear. Materials and methods Three groups matched on age and education were recruited: PC patients starting continuous ADT (ADT users) ( n = 88), PC patients not receiving ADT (PC controls) ( n = 86), and healthy controls ( n = 86). Patients retrospectively reported any falls in the 12 months prior to study entry and prospectively at 3 time points over the next 12 months (after starting ADT). Physical performance measures were done at each time point. The risks of having a fall at both baseline and over 1 year of follow-up were analyzed using logistic regression. Result At baseline 13.8% ( n = 36) of patients (ADT users = 14.7%, PC controls = 8.1%, healthy controls = 18.6%, p = 0.132) reported falls in the prior year. In the multivariable model, Timed Up and Go, marital status and working status predicted fall risk at baseline. Over 12 months, 24.8% ( n = 62) of patients (ADT users = 34.5%, PC controls = 18.1%, healthy controls = 21.7%, p = 0.035) reported falls. Prior history of falls, being unmarried and arthritis were independent predictors of falls whereas ADT use was borderline ( p = 0.08). Conclusion ADT use may be associated with an increased risk of falls, but larger confirmatory studies are needed. Additionally, multiple non-physical factors including prior history of falls and arthritis predict future falls in older men on ADT.