Pre-treatment cognitive functioning of older prostate cancer patients (PCa): Baseline data from a prospective study of androgen ablation and health status

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8175 Background: Although higher endogenous testosterone levels and testosterone supplementation have been linked to better cognitive functioning and health status, few studies have investigated potential effects of androgen ablation on cognition and functional status. Methods: PCa pts >50 yrs initiating LHRH agonist therapy for > 2 yrs, who were not on chemotherapy, and had a baseline Mini-Mental State Exam (MMSE) > 21 were enrolled. Pts completed baseline functional measures (basic/instrumental activities of daily living (A/IADLs) and Berg Balance Score (BBS)) and underwent a comprehensive neuropsychological assessment including Delayed Verbal Learning (HVLT), Delayed Visual Memory (BVMT), Working Memory (LNS), Phonemic Fluency, and Semantic Fluency. Repeat assessments are planned at 6 and 24 mths following androgen ablation initiation. Results: To date, 20 pts completed a baseline evaluation and 11 have undergone 6-mth follow-up testing. Pt characteristics include 37% African-American with a mean age of 70 and mean education of 12 yrs. At baseline, there were no deficits in ADLs or IADLs. However, 47% were at risk for falls (<40/56 on BBS). No declines in function were found at 6-mths. At baseline, 26% of pts scored between 22–26 on the MMSE suggestive of cognitive impairment. Eight of the 20 initial pts (40%) were rated cognitively impaired based on scoring > 1.5 standard deviations below the mean on 2 or more neuropsychological tests. When comparing test scores standardized for age and education, these pts were significantly more impaired than the non-impaired group across the test battery: HVLT p = .005; BVMT p =.000; LNS p=.000; Phonemic Fluency p = .028; Semantic Fluency p =.019. At 6-mth follow-up, there were no significant declines of test scores in either group. Conclusions: 40% of older men with PCa exhibit neurocognitive deficits prior to starting treatment. Follow-up to determine whether pts with pre-treatment impairment are more vulnerable to the cognitive effects of androgen ablation (e.g. dementia) is ongoing. Comparison of studies investigating the cognitive effects of androgen ablation must take baseline functioning into account. No significant financial relationships to disclose.