Cognitive effects of androgen deprivation therapy in an older cohort of men with prostate cancer.
OBJECTIVE
To determine the baseline prevalence of cognitive impairment in older men treated with ADT and to assess changes in cognitive performance over time.


RESULTS
Thirty-two patients (median age of 71 years, range 51-87) were administrated an extensive neuropsychological testing battery prior to ADT initiation, with 21 (65%) completing post-treatment evaluations 6 months later. At baseline, 45% scored >1.5 standard deviations below the mean on > or = 2 neuropsychological measures. Using standardized inferential statistics, no change in cognition was documented following treatment. The Reliable Change Index revealed that, on a case-by-case basis, 38% demonstrated a decline in measures of executive functioning and 48% showed improvement on measures of visuospatial abilities. Within exploratory analyses, patients who scored below expectation at baseline displayed no change in cognition, while patients with average or better scores at baseline displayed improvements in visuospatial planning and timed tests of phonemic fluency.


CONCLUSIONS
We found a high prevalence of lower than expected cognitive performance among a sample of patients just starting ADT for prostate cancer. Assessment of baseline cognitive function should be taken into account for future research and to inform clinical management.
Mohile
Supriya Gupta
SG
James Wilmot Cancer Center, University of Rochester, Rochester, NY 14642, USA. supriya_mohile@urmc.rochester.edu
Lacy
Maureen
M
Rodin
Miriam
M
Bylow
Kathryn
K
Dale
William
W
Meager
Michael R
MR
Stadler
Walter M
WM
D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002277:Carcinoma / Q000188:drug therapy* / Q000523:psychology; D003071:Cognition / Q000187:drug effects* / Q000502:physiology; D015331:Cohort Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011471:Prostatic Neoplasms / Q000188:drug therapy* / Q000523:psychology
D000726:Androgen Antagonists; D000970:Antineoplastic Agents