The effect of ADT on objective cognitive performance and self-reported cognitive functionin men with prostate cancer.

Abstract

4560 Background: ADT is used to treat almost 50% of prostate cancer (PC) patients. Despite slowing disease progression and prolonging survival, ADT is associated with numerous side effects. However, the impact of ADT on self-reported and objective cognitive function remains unclear. Methods: Three groups of males age 50+ were included; PC patients starting continuous ADT (n=77), PC controls not receiving ADT (n=85), and healthy controls (n=83). A self-reported cognitive function questionnaire (FACT-Cog) and a battery of neuropsychological tests examining 8 cognitive domains were administered at baseline, 6 months and 12 months later. The FACT-Cog scores and the battery test scores were compared between groups at baseline, and change scores over the 12 month period were analyzed using ANOVA and multi-variable linear regression. To examine whether changes in objective cognitive scores correlated with changes in FACT-Cog scores, Pearson correlations were calculated. Results: FACT- Cog scores obtained at baseline did not significantly differ between the 3 groups (p>0.05). ADT users did not report a greater decline in self-cognitive function overtime compared to PC controls or healthy controls (p=0.21). Attention and Processing Speed, Visual Memory, Language and Executive Function scores did not significantly differ between groups (p>0.05). At 12 months, ADT users had significantly declined on the Longest Digit Span Forwards (Immediate Memory), Spatial Span Backwards (Working Memory), and Card Rotations tasks (Visuospatial Ability) (p<0.05). Correlations between FACT-Cog and objective cognitive test scores were weak at baseline and overtime (all r<0.20). Conclusions: Preliminary analyses suggest little or no deleterious effect of ADT on self-reported cognitive function over 12 months. Objective cognitive performance of ADT users declined over 12 months on 3 cognitive tests, indicating a possibility of ADT's long-term impact on selected cognitive domains. Correlations between FACT-Cog scores and objective cognitive performance were poor. No significant financial relationships to disclose.