In Reply We thank Welsh and Hentz, and Kim and Chung for their interest in our recent article1 on the association of androgen deprivation therapy (ADT) with increased dementia risk. We agree with Welsh and Hentz that stratification by the form of ADT is an important future step in understanding the association of ADT and the risk of dementia. As the authors highlight, the various forms of ADT used in practice have differing effects on the hypothalamic–pituitary–gonadal axis and could reasonably be hypothesized to have distinct effects on dementia risk. This may explain, and continue to contribute to, variability in effect sizes of studies examining the association of ADT and dementia outcomes. We fully agree with Welsh and Hentz that the analysis of prospective data for men with prostate cancer who received distinct forms of ADT will best clarify the true association of ADT and dementia.
Nead KT, Swisher-McClure S, Shah NH. Androgen Deprivation Therapy and Subsequent Dementia—Reply. JAMA Oncol. Published online May 04, 2017. doi:10.1001/jamaoncol.2017.0405