PD13-08 ANALYZING THE ASSOCIATION BETWEEN EXPOSURE TO ANDROGEN DEPRIVATION THERAPY AND THE ONSET OF ALZHEIMER'S DISEASE AND DEMENTIA IN MEN WITH PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology & Natural History I (PD13)1 Apr 2020PD13-08 ANALYZING THE ASSOCIATION BETWEEN EXPOSURE TO ANDROGEN DEPRIVATION THERAPY AND THE ONSET OF ALZHEIMER'S DISEASE AND DEMENTIA IN MEN WITH PROSTATE CANCER Peter E Lonergan*, Samuel L Washington, Shoujun Zhao, Janet E Cowan, Jeanette M Broering, and Peter R Carroll Peter E Lonergan*Peter E Lonergan* More articles by this author , Samuel L WashingtonSamuel L Washington More articles by this author , Shoujun ZhaoShoujun Zhao More articles by this author , Janet E CowanJanet E Cowan More articles by this author , Jeanette M BroeringJeanette M Broering More articles by this author , and Peter R CarrollPeter R Carroll More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000847.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Recent studies have suggested an association between androgen deprivation therapy (ADT) and an increased risk of Alzheimer’s disease and/or dementia (ADD) in men with prostate cancer; however this effect is not conclusive. We sought to examine the association between exposure to ADT and the onset of ADD in a nationwide registry of men diagnosed with prostate cancer, primarily in community-based urological practices. METHODS: A retrospective review of prospectively collected data from the national CaPSURE cohort study between 1995 and 2017 was performed. Men diagnosed with prostate cancer aged ≥ 65 years and without a pre-existing diagnosis of ADD were included. ADT was defined as LHRH agonist or antagonist. Onset of dementia was identified using ICD9/10 codes at office visits/hospitalizations, medication use, or change in study status due to dementia symptoms reported by proxy. A multivariable competing risk regression analysis, with all-cause mortality as the competing risk, was performed to determine if there was an association between ADT exposure and the onset of ADD. Preliminary models tested for interactions between age, CAPRA risk and ADT exposure. The final model was adjusted for ADT exposure, age, sociodemographics, comorbidities, clinical CAPRA score and year of treatment. RESULTS: From 15,310 men enrolled, 7,957 met the study criteria. 4,916 men (62%) received no ADT, 1,434 men (18%) received ADT following local treatment and 1,607 (20%) had primary ADT. The median follow up was 7.0 years (IQR 4.0-11.0). ADD occurred in 264 men at a median (IQR) of 8.0 years (4.0-12.0). Life table estimates of onset were 2% at 7 years and 6% at 14 years after treatment. Estimates of all-cause death were 7% at 7 years and 37% at 14 years. On multivariable competing risk model (see figure), onset of ADD was not independently associated with ADT, while age and clinical CAPRA at diagnosis were significantly associated with risk of onset. The interaction terms representing ADT exposure with age and with CAPRA also were not significant. CONCLUSIONS: In our cohort ADT was not associated with the onset of ADD when accounting for all-cause mortality as a competing risk. Age and disease characteristics were more closely associated with risk of onset. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e269-e269 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Peter E Lonergan* More articles by this author Samuel L Washington More articles by this author Shoujun Zhao More articles by this author Janet E Cowan More articles by this author Jeanette M Broering More articles by this author Peter R Carroll More articles by this author Expand All Advertisement PDF downloadLoading ...