Cognitive function in patients on androgen suppression: A prospective, multicentric study

Actas Urol Esp (Engl Ed). 2018 Mar;42(2):114-120. doi: 10.1016/j.acuro.2017.04.007. Epub 2017 Nov 6.
[Article in English, Spanish]

Abstract

Objective: To assess the effect of androgen deprivation therapy (ADT) on cognitive performance (CP) in patients with prostate cancer (PCa) after 6 months of treatment with luteinizing hormone-releasing hormone (LHRH) analogues.

Material and methods: Prospective, observational, multicentre, open-label study of patients diagnosed with nonmetastatic or asymptomatic metastatic PCa scheduled to receive LHRH analogues for≥6 months. We assessed four CP domains at baseline and after 6 months of ADT: 1) Working memory: Wechsler Adult Intelligence Scale III (WAIS III) Digit Span Subtest (WAIS III-Digit); 2) Visual memory: ad hoc visual memory test; 3) Visuospatial ability: Judgement of Line Orientation (JLO) and Mental Rotation of Three-Dimensional Objects (3D-Rotation); and 4) Nonverbal analytical reasoning: WAIS III Matrix Reasoning Test (WAIS III-MRT). Changes outside the baseline 95% confidence intervals were considered significant.

Results: A total of 308 patients completed the study. Of these, 245 (79.6%) experienced no statistically significant changes on any test and 63 patients (20.4%) experienced significant changes in ≥1 test. Of these, most presented a change in only one test, distributed evenly between improvements (58 patients; 18.8%) and worsening (56 patients; 18.2%). For individual tests, most patients (87.8% to 91.8%) had no change from baseline; however, the significant changes (improvement vs. deterioration, respectively) were as follows: WAIS III-Digit (6.3% vs. 5.9%); visual memory (5.3% vs. 5.7%); JLO (5.3% vs. 4.5%); 3D-Rotation (4.1% vs. 4.1%); and WAIS III-MRT (4.8% vs. 5.8%).

Conclusions: CP in patients with PCa does not appear to be adversely affected by 6 months of LHRH analogue administration.

Keywords: Androgen deprivation therapy; Análogos de la hormona liberadora de la hormona luteinizante; Cognitive function; Cáncer de próstata; Función cognitiva; Luteinizing hormone-releasing hormone analogues; Prostate cancer; Supresión androgénica.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Androgen Antagonists / adverse effects*
  • Antineoplastic Agents, Hormonal / adverse effects*
  • Cognition / drug effects*
  • Cognition Disorders / chemically induced*
  • Gonadotropin-Releasing Hormone / agonists
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Prospective Studies
  • Spatial Memory / drug effects
  • Spatial Navigation / drug effects
  • Wechsler Scales

Substances

  • Androgen Antagonists
  • Antineoplastic Agents, Hormonal
  • Gonadotropin-Releasing Hormone