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Research Letter
November 2018

Association of Androgen Deprivation Therapy With Dementia in Men With Prostate Cancer Who Receive Definitive Radiation Therapy

Author Affiliations
  • 1Veterans Affairs San Diego Health Care System, La Jolla, California
  • 2Department of Radiation Medicine and Applied Sciences, University of California San Diego School of Medicine, La Jolla
  • 3University of California San Diego Center for Precision Radiation Medicine, La Jolla
JAMA Oncol. 2018;4(11):1616-1617. doi:10.1001/jamaoncol.2018.4423

There is conflicting evidence on the association of androgen deprivation therapy (ADT) and dementia.1-4 Two studies1,2 reported a strong statistically significant association between ADT and both dementia and Alzheimer disease in patients with prostate cancer (PC). However, these studies1,2 analyzed heterogeneous populations, including patients with localized and metastatic disease, treated with curative and palliative intent, and ADT use in the upfront or recurrent setting.1,2 Different treatment modalities and disease stages are associated with substantial selection bias that may predispose results to false associations.5 Furthermore, an association between ADT use and dementia in the recurrent or metastatic setting may be confounded by factors, such as chronic pain, or salvage treatments, such as chemotherapy. We hypothesized that there is no statistically significant association between ADT use and the development of dementia in men with PC who received definitive radiotherapy after controlling for multiple sources of selection bias.

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