title: Influence of age on androgen deprivation therapy-associated Alzheimer's disease.
abstract: We recently found an association between androgen deprivation therapy (ADT) and Alzheimer's disease. As Alzheimer's disease is a disease of advanced age, we hypothesize that older individuals on ADT may be at greatest risk. We conducted a retrospective multi-institutional analysis among 16,888 individuals with prostate cancer using an informatics approach. We tested the effect of ADT on Alzheimer's disease using Kaplan-Meier age stratified analyses in a propensity score matched cohort. We found a lower cumulative probability of remaining Alzheimer's disease-free between non-ADT users age ≥70 versus those age <70 years (p < 0.001) and between ADT versus non-ADT users ≥70 years (p = 0.034). The 5-year probability of developing Alzheimer's disease was 2.9%, 1.9% and 0.5% among ADT users ≥70, non-ADT users ≥70 and individuals <70 years, respectively. Compared to younger individuals older men on ADT may have the greatest absolute Alzheimer's disease risk. Future work should investigate the ADT Alzheimer's disease association in advanced age populations given the greater potential clinical impact.
authors.affiliation: Stanford Center for Biomedical Informatics Research, Stanford University, 1265 Welch Road, Stanford, California, 94305, USA.|Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, Pennsylvania, 19104, USA.
authors.forename: Kevin T
authors.initials: KT
authors.lastname: Nead
authors.affiliation: Stanford Center for Biomedical Informatics Research, Stanford University, 1265 Welch Road, Stanford, California, 94305, USA.
authors.forename: Greg
authors.initials: G
authors.lastname: Gaskin
authors.affiliation: Stanford Center for Biomedical Informatics Research, Stanford University, 1265 Welch Road, Stanford, California, 94305, USA.
authors.forename: Cariad
authors.initials: C
authors.lastname: Chester
authors.affiliation: Department of Radiation Oncology, University of Pennsylvania Perelman School of Medicine, 3400 Civic Center Boulevard, Philadelphia, Pennsylvania, 19104, USA.
authors.forename: Samuel
authors.initials: S
authors.lastname: Swisher-McClure
authors.affiliation: Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, 10029, USA.
authors.forename: Joel T
authors.initials: JT
authors.lastname: Dudley
authors.affiliation: Stanford Cardiovascular Institute, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, California, 94305, USA.
authors.forename: Nicholas J
authors.initials: NJ
authors.lastname: Leeper
authors.affiliation: Stanford Center for Biomedical Informatics Research, Stanford University, 1265 Welch Road, Stanford, California, 94305, USA.
authors.forename: Nigam H
authors.initials: NH
authors.lastname: Shah
mesh_terms: D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D000728:Androgens / Q000378:metabolism*; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D012306:Risk; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
chemical_list: D000728:Androgens