title: Long-term impact of androgen-deprivation therapy on physical function and quality of life.
abstract: BACKGROUND
  This study examined the impact of androgen-deprivation therapy (ADT) on physical function and quality of life (QOL) over 36 months.
  
  
  METHODS
  Eighty-seven men with nonmetastatic prostate cancer (PC) who were starting continuous ADT and 2 control groups (86 PC controls without ADT and 86 healthy controls), matched by age and education, were enrolled. Physical function was assessed with the 6-minute walk test (6MWT), grip strength, and Timed Up and Go (TUG) test. QOL was measured with the 36-Item Short Form Health Survey of the Medical Outcomes Study. Subjects were assessed at the baseline and at 3, 6, 12, 18, 24, 30, and 36 months. Mixed effects regression models were fitted with adjustments for baseline covariates.
  
  
  RESULTS
  The 6MWT distance improved initially and then stabilized in both control groups but remained unchanged for ADT users (P = .0030). Grip strength remained stable in control groups but declined sharply in the ADT group by 3 months and then remained stable to 36 months (P = .0041). TUG scores declined gradually in the ADT group over 36 months but were unchanged in control groups (P = .0008). Aggregate physical QOL declined in ADT users over time but remained stable in control groups (P = .0001). Aggregate mental QOL was stable in all groups. Declines seen in the first year of ADT use generally persisted over 36 months and were independent of age.
  
  
  CONCLUSIONS
  Previously noted physical side effects over the first 12 months of ADT persisted or continued to worsen over an additional 2 years with no evidence of recovery. Exercise interventions to counteract these declines may be warranted.
authors: Department of Medicine, University Health Network, Toronto, Canada.|Department of Medicine, University of Toronto, Toronto, Canada.|Institute of Health Policy, Management, and Evaluation, Toronto, Canada.
authors: Shabbir M H
authors: SM
authors: Alibhai
authors: Department of Medicine, University Health Network, Toronto, Canada.
authors: Henriette
authors: H
authors: Breunis
authors: Department of Medicine, University Health Network, Toronto, Canada.
authors: Narhari
authors: N
authors: Timilshina
authors: Department of Medicine, University of Toronto, Toronto, Canada.|Institute of Health Policy, Management, and Evaluation, Toronto, Canada.|Baycrest Centre for Geriatric Care, Toronto, Canada.
authors: Gary
authors: G
authors: Naglie
authors: Department of Medicine, University Health Network, Toronto, Canada.|Department of Medicine, University of Toronto, Toronto, Canada.
authors: Ian
authors: I
authors: Tannock
authors: Department of Medicine, University Health Network, Toronto, Canada.|Department of Medicine, University of Toronto, Toronto, Canada.|Institute of Health Policy, Management, and Evaluation, Toronto, Canada.
authors: Murray
authors: M
authors: Krahn
authors: Department of Radiation Oncology, University of Toronto, Toronto, Canada.
authors: Padraig
authors: P
authors: Warde
authors: Department of Surgery, University of Toronto, Toronto, Canada.
authors: Neil E
authors: NE
authors: Fleshner
authors: Department of Neurosciences, University Health Network, Toronto, Canada.
authors: Sarah Duff
authors: SD
authors: Canning
authors: Department of Medicine, University Health Network, Toronto, Canada.|Department of Medicine, University of Toronto, Toronto, Canada.|Institute of Health Policy, Management, and Evaluation, Toronto, Canada.|Department of Public Health Sciences, University of Toronto, Toronto, Canada.
authors: George
authors: G
authors: Tomlinson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000008:administration & dosage* / Q000009:adverse effects*; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D016022:Case-Control Studies; D004334:Drug Administration Schedule; D018737:Hand Strength; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000188:drug therapy*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D016138:Walking
chemical_list: D000726:Androgen Antagonists; D000970:Antineoplastic Agents
keywords: activities of daily living; androgen-deprivation therapy; physical function; prospective study; prostate carcinoma; quality of life