Low Testosterone Linked with Alzheimer’s Disease Risk

Kevin T. Nead and colleagues evaluated medical records from the Stanford health system and New York’s Mount Sinai Hospital for 16,888 nonmetastatic prostate cancer patients, of whom 2,397 received androgen deprivation therapy. Men treated with androgen deprivation therapy for various lengths of time were matched with control patients who did not receive the ther­apy. Researchers discovered that men who received the therapy were 88% more likely to develop Alzheimer’s over follow-up. Longer androgen depriva­tion therapy duration (equal to or greater than 12 months) was associated with more than double the risk of developing Alzheimer’s.

Editor’s Note: “Based on the results of our study, an increased risk of Alzheimer’s disease is a potential adverse effect of androgen deprivation therapy, but further research is needed before considering changes to clinical practice,” Dr. Nead noted. It is regrettable that this therapy must be employed to save the lives of certain prostate cancer patients. These findings help reinforce a strategy that men with advancing prostate cancer who need to block testosterone production should consider intermittent androgen deprivation therapy, in which therapy is stopped after the PSA falls to a low level, usually after 3-9 months. Androgen deprivation therapy is resumed only if the PSA increases significantly. By carefully monitoring PSA blood levels, androgen deprivation can often be used sparingly to control PSA levels while maintaining quality of life.