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Unraveling the Complex Relationship Between Androgen Deprivation Therapy and Dementia: A Deep Dive into Current Research

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Introduction

Prostate cancer is a prevalent health issue for men worldwide, necessitating urgent focus on its treatment and related complications. Androgen Deprivation Therapy (ADT), a mainstay in prostate cancer management, reduces androgen levels that fuel the growth of cancer cells. However, the association of ADT with various forms of dementia, including Alzheimer’s disease (AD), vascular dementia, and Parkinson’s disease (PD), is a matter of pressing concern. This study aims to illuminate the potential risks of these cognitive disorders in patients undergoing ADT, thereby contributing to improved patient care.




Background

Prostate cancer significantly impacts men's health, and ADT has emerged as a key treatment option. Understanding the side effects of ADT is vital for holistic patient care. Dementia, a severe cognitive impairment, drastically affects life quality. Its potential connection with ADT is crucial for patients and healthcare providers alike. Alzheimer’s disease, the most prevalent form of dementia, along with vascular dementia and Parkinson’s disease, pose significant health challenges, particularly in older adults.

Methodology

A thorough search was conducted across PubMed, EMBASE, Scopus, and Google Scholar to identify relevant studies. The selection criteria focused on systematic review methods to facilitate comparison between ADT receivers and non-receivers, controlling for biases. The review identified 305 studies, with 28 meeting the inclusion criteria. Heterogeneity was assessed using Higgins I2%, with variables over 50% considered heterogeneous and analyzed using a Random-Effects model, while a Fixed-Effects model was employed otherwise.

Results

The analysis included 28 studies, involving a total of 2,543,483 patients: 900,994 with prostate cancer who received ADT, 1,262,905 who did not, and 379,584 without prostate cancer. This revealed increased Hazard Ratios (HR) for dementia (HR 1.20), Alzheimer’s Disease (HR 1.26), depression (HR 1.66), and Parkinson’s Disease (HR 1.57). The risk for vascular dementia was also notable (HR 1.30).

Conclusion and Future Perspectives

The evidence suggests that ADT significantly raises the risk of dementia, AD, PD, and depression. These findings underscore the need for careful consideration when prescribing ADT and highlight the importance of monitoring cognitive health in patients undergoing this treatment. Future research should focus on developing strategies to mitigate these risks, offering hope for safer, more effective prostate cancer treatments.

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