Hormonal therapy and cognitive function

Preliminary results from a University of Toronto study indicate that androgen deprivation therapy (ADT) does not affect most cognitive domains, and may even be associated with a slight improvement in some areas of cognitive function.

This prospective study examined changes in cognitive function over time in three groups of men who were matched for age (mean age
68.9 years) and education level (mean, 15.7 years): 1) prostate cancer patients starting ADT; 2) prostate cancer patients not receiving ADT; and 3) a “control” group made up of healthy men. The men underwent neuropsychological testing before the start of ADT (baseline), at six months and again at 12 months.

All three groups of men had similar cognitive scores in most areas at baseline. Scores for attention and processing speed, visuospatial ability and visual memory remained about the same for all groups from baseline to 12 months. At 12 months, the men on ADT (Group 1) had significantly improved immediate and working memory test scores compared to the healthy controls (Group 3). They also did
better on executive function tests (card rotations, colour naming) and language fluency tests. Compared to the healthy group, the prostate cancer patients not on ADT (Group 2) had only improved on the immediate memory scores at 12 months.

According to the researchers, these preliminary conclusions may be reassuring to patients and clinicians who are concerned about the effects of ADT on mental functioning.