ObjectiveAndrogen deprivation therapy (ADT) is a common treatment for prostate cancer (PCa), with increasing numbers of men on ADT for longer. Limited evidence suggests ADT impacts cognition. This study addressed gaps in the literature by focusing on older men with PCa and assessing ADT usage longer than 1 year.MethodsThis study of 133 men ≥65 years of age with PCa included two groups: (1) men on ADT for 1–3 years (ADT‐exposed), and (2) a comparison group of men with PCa not on ADT (ADT‐unexposed). Group comparisons on individual neuropsychological test scores are reported, as well as effect sizes (Cohen's d).ResultsHalf (n = 67) of the sample was ADT‐exposed and half (n = 66) were unexposed. The average age was 72 years, most were White, and over 50% had at least secondary education. There were no statistically significant differences between groups by age, race, or education. Unadjusted analyses showed the ADT‐exposed group, compared with the ADT‐unexposed group, performed significantly lower in domains of verbal learning (d = 0.45–0.52, p = 0.01 to <0.01), verbal recall (d = 0.33–0.54, p = 0.06 to <0.01), and possible effects in visuospatial construction (d = 0.33, p = 0.08 to 0.06). When controlling for age and education, similar patterns emerged. The ADT exposed‐group performed significantly lower in domains of verbal learning (d = 0.45–0.52, p = 0.06 to 0.03) and verbal recall (d = 0.33–0.54, p = 0.11 to 0.03), and possible effects in visuospatial construction d = 0.33, p = 0.18 to 0.13.ConclusionsThis study suggests long‐term ADT exposure impacts verbal learning, verbal recall, and possibly visuospatial abilities in older men (≥65) with PCa. The potential cognitive effects of ADT should be discussed with older patients considering long‐term use of ADT.

中文翻译：

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长期雄激素剥夺治疗对患有前列腺癌的老年男性的认知影响

目的雄激素剥夺疗法 (ADT) 是前列腺癌 (PCa) 的常见治疗方法，越来越多的男性接受更长时间的 ADT。有限的证据表明 ADT 会影响认知。这项研究通过关注患有 PCa 的老年男性并评估 ADT 使用时间超过 1 年来弥补文献中的空白。方法这项研究对 133 名 ≥ 65 岁的 PCa 男性进行了研究，包括两组：(1) 接受 ADT 1-3 年的男性（ADT 暴露），以及（2）未接受 ADT 的 PCa 男性对照组（ADT 未暴露）。报告了个体神经心理学测试分数的组比较以及效应大小（科恩的d).结果一半(n= 67) 的样品暴露于 ADT，一半 (n= 66) 未暴露。平均年龄为 72 岁，大多数是白人，超过 50% 的人至少受过中等教育。年龄、种族或教育程度各组之间没有统计学上的显着差异。未经调整的分析显示，与未暴露于 ADT 的组相比，暴露于 ADT 的组在言语学习领域的表现显着较低（d= 0.45–0.52，p= 0.01 至 <0.01)，口头回忆 (d= 0.33–0.54，p= 0.06 至 <0.01），以及视觉空间构建中可能产生的影响（d= 0.33,p= 0.08 至 0.06）。当控制年龄和教育程度时，出现了类似的模式。 ADT 暴露组在言语学习领域的表现显着较低（d= 0.45–0.52，p= 0.06 至 0.03) 和言语回忆 (d= 0.33–0.54，p= 0.11 至 0.03），以及视觉空间构建中可能产生的影响d= 0.33,p= 0.18 至 0.13。结论本研究表明，长期 ADT 暴露会影响患有 PCa 的老年男性（≥65 岁）的言语学习、言语记忆，以及可能的视觉空间能力。应与考虑长期使用 ADT 的老年患者讨论 ADT 的潜在认知影响。