Cognitive Performance Quality of Life and Psychosocial Adjustment Among Men Receiving Androgen Deprivation Therapy for Treatment of Prostate Cancer

摘要

Animal models and naturalistic studies of androgen decline in aging men suggest that low testosterone levels contribute to cognitive difficulties. Suppression of testosterone by androgen deprivation therapy (ADT) is the preferred treatment for advanced prostate cancer (PC) and in recent years has been increasingly prescribed for treatment of early stage PC. Although many of the side effects of ADT are well documented, potential cognitive impairment associated with ADT has been neglected in the literature. Our preexisting data indicate that 35% of men receiving ADT report moderate to sever difficulties with attention, concentration, and memory. In addition to normal age-related declines in cognitive function, men receiving ADT may experience hormone-related cognitive impairments that remain undetected and untreated. This study describes the nature and prevalence of objectively assessed cognitive difficulties in PC patients treated with ADT, examines the relationship between subjective reports of cognitive impairment and objective measurement of cognitive performance, and assesses relationships among fatigue, psychological distress, and cognitive function. Preliminary results show that 58% of the men have cognitive deficits greater than or equal to 1 SD below age- and education-adjusted population norms in one or more cognitive domains, and 92% have at least one area of performance greater than or equal to 1 SD below expected functioning based on estimated premorbid IQ.