Tae BS, et al. J Korean Med Sci. 2017 Nov;33(2):e13. https://doi.org/10.3346/jkms.2018.33.e13

The purpose of this study was to evaluate the association of androgen deprivation therapy (ADT) with cognitive dysfunction. Using the National Health Insurance Service database of the entire Korean adult prostate cancer population (n=236,391), data on ADT and cognitive dysfunction between 2008 and 2015 were analyzed. We excluded patients previously diagnosed with cognitive dysfunction, dementia, or a cerebral event history. We tested the effect of ADT on the risk of cognitive dysfunction using propensity score-matched Cox proportional hazards regression models and Kaplan-Meier survival analysis. Our final cohort comprised of 35,401 individuals with prostate cancer, including 24,567 men (70.6%) who underwent ADT. During a mean follow-up period of 4.1 years, 4,741 patients were newly diagnosed with cognitive dysfunction. A statistically significant association was found between ADT and the risk of cognitive dysfunction (hazard ratio, 1.169; p=0.002). Meanwhile, age (≥ 70 years), diabetes, hypertension, cardiovascular history, and peripheral vascular disease were identified as factors that contribute to the increased risk of cognitive dysfunction. In contrast, the use of statins and aspirin was associated with a lower risk of cognitive dysfunction. Kaplan-Meier analysis demonstrated that patients aged 70 years or older who underwent ADT had the lowest cumulative probability of remaining cognitive dysfunction-free (log-rank p < 0.001). Our. revealed an association between the use of ADT for the treatment of prostate cancer and an increased risk of cognitive dysfunction in a nationwide population-based study. This finding should be further evaluated in prospective studies.

Purpose:A recent study demonstrated that use of tamsulosin increased the risk of dementia in benign prostate hyperplasia patients. However, this study had a number of limitations. We evaluated the association between alpha-blockers and dementia in patients with benign prostate hyperplasia.Methods:From the National Health Insurance Service database, we collected and analyzed data pertaining to alpha-blockers and dementia in the entire Korean adult population with benign prostate hyperplasia between January 2011 and December 2011. These patients were followed up until September 2017. We tested the effect of alpha-blockers on the risk of dementia using propensity score-matched Cox proportional hazard regression models and Kaplan-Meier survival analysis.Results:During a mean follow-up period of 1,580 (± 674.3) days, all inclusion and exclusion criteria were met by 59,263 patients with benign prostate hyperplasia. In the unadjusted cohort, the incidence of dementia in the tamsulosin, doxazosin, terazos...