Skip to main content
Key Specialties
Anesthesiology Cardiology Dermatology Diabetology Endocrinology Gastroenterology General Medicine Geriatrics Hematology Infectious Diseases Internal Medicine Nephrology Neurology Obstetrics and Gynecology Oncology Pediatrics Psychiatry Radiology Respiratory Medicine Rheumatology Surgery Urology
Congress Coverage
2024 ESMO Congress 2024 ERS Congress 2024 EASD Congress 2024 ESC Congress 2024 EAN Congress 2024 ASCO Annual Meeting 2024 ACC Congress
Clinical Collections
Advances in Alzheimer’s

EASD 2024

Keep up to date with the top stories from the 60th EASD Annual Meeting with our congress hub page.
ADVANCED SEARCH
Log in
Top
The Journal of Prevention of Alzheimer's Disease
Published in:

01-04-2023 | Alzheimer's Disease | Original Research

A Large Retrospective Cohort Study on the Risk of Alzheimer’s Disease and Related Dementias in Association with Vascular Diseases and Cancer Therapy in Men with Prostate Cancer

Authors: Xianglin L. Du, L. Song

Published in: The Journal of Prevention of Alzheimer's Disease | Issue 2/2023

Login to get access

Abstract

Background

No study was conducted on the long-term risk of Alzheimer’s disease (AD) and related dementias (ADRD) in association with vascular diseases in men with prostate cancer.

Objectives

To determine the 26-year risk of ADRD in association with cardiovascular disease (CVD), stroke, hypertension, and diabetes in a nationwide cohort of men with prostate cancer.

Design

Retrospective cohort study.

Setting

Surveillance, Epidemiology, and End Results (SEER) areas of the United States.

Participants

351,571 men diagnosed with prostate cancer at age ≥65 years.

Measurements

Main exposures were CVD, stroke, hypertension, and diabetes. Main outcome was the incidence of ADRD.

Results

The crude 26-year cumulative incidence of any ADRD was higher in those with versus without CVD (33.80% vs 29.11%), stroke (40.70% vs 28.03%), hypertension (30.88% vs 27.31%), and diabetes (32.23% vs 28.68%). Men with CVD (adjusted hazard ratio: 1.17, 95% CI: 1.15–1.20), stroke (1.59, 1.56–1.61), hypertension (1.13, 1.11–1.14), and diabetes (1.25, 1.23–1.27) were significantly more likely to develop ADRD than those without. Patients with 4 of these vascular diseases were 161% more likely to develop ADRD (2.61, 2.47–2.76) than those without. The risk of AD (0.89, 0.87–0.91) and ADRD (0.91, 0.90–0.93) became significantly lower in men with prostate cancer who received androgen deprivation therapy as compared to those who did not after considering death as a competing risk.

Conclusions

In men with prostate cancer, vascular diseases were associated with significantly higher risks of developing ADRD. Androgen deprivation therapy was associated with a significantly decreased risk of AD in men with prostate cancer.
Appendix
Available only for authorised users
Literature
1.
Alzheimer’s Association. 2022 Alzheimer’s Disease Facts and Figures. Alzheimers Dement. 2022;18:700–789.
2.
3.
Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer disease in the United States (2010–2050) estimated using the 2010 Census. Neurology. 2013;80:1778–1783.PubMedPubMedCentral
4.
Matthews KA, Xu W, Gaglioti AH, Holt JB, Croft JB, Mack D, McGuire LC. Racial and ethnic estimates of Alzheimer’s disease and related dementias in the United States (2015–2060) in adults aged ≥ 65 years. Alzheimers Dement. 2019;15:17–24.PubMed
5.
GBD 2016 Dementia Collaborators. Global, regional, and national burden of Alzheimer’s disease and other dementias, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18:88–106.
6.
Chêne G, Beiser A, Au R, Preis SR, Wolf PA, Dufouil C, Seshadri S. Gender and incidence of dementia in the Framingham Heart Study from mid-adult life. Alzheimers Dement. 2015;11:310–320.PubMed
7.
Rosendorff C, Beeri MS, Silverman JM. Cardiovascular risk factors for Alzheimer’s disease. Am J Geriatr Cardiol. 2007;16:143–149.PubMed
8.
Almeida OP, Flicker L. The mind of a failing heart: a systematic review of the association between congestive heart failure and cognitive functioning. Intern Med J. 2001;31:290–295.PubMed
9.
Purnell C, Gao S, Callahan CM, Hendrie HC. Cardiovascular risk factors and incident Alzheimer disease: a systematic review of the literature. Alzheimer Dis Assoc Disord. 2009;23:1–10.PubMedPubMedCentral
10.
Knopman DS, Mosley TH, Catellier DJ, Coker LH. Fourteen-year longitudinal study of vascular risk factors, APOE genotype, and cognition: the ARIC MRI Study. Alzheimers Dement. 2009;5:207–214.PubMed
11.
Gottesman RF, Albert MS, Alonso A, Coker LH, Coresh J, Davis SM, Deal JA, McKhann GM, Mosley TH, Sharrett AR, Schneider ALC, Windham BG, Wruck LM, Knopman DS. Associations Between Midlife Vascular Risk Factors and 25-Year Incident Dementia in the Atherosclerosis Risk in Communities (ARIC) Cohort. JAMA Neurol. 2017;74:1246–1254.PubMedPubMedCentral
12.
Pendlebury ST, Rothwell PM; Oxford Vascular Study. Incidence and prevalence of dementia associated with transient ischaemic attack and stroke: analysis of the population-based Oxford Vascular Study. Lancet Neurol. 2019;18:248–258.PubMedPubMedCentral
13.
Peters R, Booth A, Rockwood K, Peters J, D’Este C, Anstey KJ. Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis. BMJ Open. 2019;9:e022846.PubMedPubMedCentral
14.
Yaffe K, Vittinghoff E, Hoang T, Matthews K, Golden SH, Zeki Al Hazzouri A. Cardiovascular Risk Factors Across the Life Course and Cognitive Decline: A Pooled Cohort Study. Neurology. 2021;96:e2212–e2219.PubMedPubMedCentral
15.
Yassi N, Pase MP, Buckley RF, Rosenich E, Watson R, Maruff P, Lim YY. Cardiovascular Risk Associated with Poorer Memory in Middle-Aged Adults from the Healthy Brain Project. J Alzheimers Dis. 2022;86:1081–1091.PubMed
16.
Skoog I, Lernfelt B, Landahl S, Palmertz B, Andreasson LA, Nilsson L, Persson G, Oden A, Svanborg A. 15-year longitudinal study of blood pressure and dementia. Lancet. 1996;347:1141–1145.PubMed
17.
Havlik RJ, Foley DJ, Sayer B, Masaki K, White L, Launer LJ. Variability in midlife systolic blood pressure is related to late-life brain white matter lesions: the Honolulu-Asia Aging study. Stroke. 2002;33:26–30.PubMed
18.
Roberts RO, Knopman DS, Przybelski SA, Mielke MM, Kantarci K, Preboske GM, Senjem ML, Pankratz VS, Geda YE, Boeve BF, Ivnik RJ, Rocca WA, Petersen RC, Jack CR Jr. Association of type 2 diabetes with brain atrophy and cognitive impairment. Neurology. 2014; 82:1132–1141.PubMedPubMedCentral
19.
Biessels GJ, De Leeuw FE, Lindeboom J, Barkhof F, Scheltens P. Increased cortical atrophy in patients with Alzheimer’s disease and type 2 diabetes mellitus. J Neurol Neurosurg Psychiatry. 2006;77:304–307.PubMedPubMedCentral
20.
Irie F, Fitzpatrick AL, Lopez OL, Kuller LH, Peila R, Newman AB, Launer LJ. Enhanced risk for Alzheimer disease in persons with type 2 diabetes and APOE epsilon4: the Cardiovascular Health Study Cognition Study. Arch Neurol. 2008;65:89–93.PubMed
21.
Du XL, Song L, Schulz PE, Xu H, Chan W. Risk of developing Alzheimer’s disease and related dementias in association with cardiovascular disease, stroke, hypertension and diabetes in a large cohort of women with breast cancer and with up to 26 years of follow-up. J Alzheimers Dis. 2022;87:415–432.PubMedPubMedCentral
22.
Roe CM, Fitzpatrick AL, Xiong C, Sieh W, Kuller L, Miller JP, Williams MM, Kopan R, Behrens MI, Morris JC. Cancer linked to Alzheimer disease but not vascular dementia. Neurology. 2010;12:106–112.
23.
Bennett DA, Leurgans S. Is there a link between cancer and Alzheimer disease?. Neurology. 2010;12:100–101.
24.
Driver JA, Beiser A, Au R, Kreger BE, Splansky GL, Kurth T, Kiel DP, Lu KP, Seshadri S, Wolf PA. Inverse association between cancer and Alzheimer’s disease: results from the Framingham Heart Study. BMJ. 2012;344:e1442.PubMedPubMedCentral
25.
Musicco M, Adorni F, Di Santo S, Prinelli F, Pettenati C, Caltagirone C. Inverse occurrence of cancer and Alzheimer disease: a population-based incidence study. Neurology. 2013;81:322–328.PubMed
26.
Driver JA. Inverse association between cancer and neurodegenerative disease: review of the epidemiologic and biological evidence. Biogerontology. 2014;15:547–557.PubMed
27.
Ma LL, Yu JT, Wang HF, Meng XF, Tan CC, Wang C, Tan L. Association between cancer and Alzheimer’s disease: systematic review and meta-analysis. J Alzheimers Dis. 2014;42:565–573.PubMed
28.
Zhang Q, Guo S, Zhang X, Tang S, Shao W, Han X, Wang L, Du Y. Inverse relationship between cancer and Alzheimer’s disease: a systemic review meta-analysis. Neurol Sci. 2015;36:1987–1994.PubMed
29.
Ospina-Romero M, Abdiwahab E, Kobayashi L, Filshtein T, Brenowitz WD, Mayeda ER, Glymour MM. Rate of Memory Change Before and After Cancer Diagnosis. JAMA Netw Open. 2019;5:e196160.
30.
Ospina-Romero M, Glymour MM, Hayes-Larson E, Mayeda ER, Graff RE, Brenowitz WD. Association Between Alzheimer Disease and Cancer With Evaluation of Study Bias: Systematic Review and Meta-analysis. JAMA Netw Open. 2020;3:e2025515.PubMedPubMedCentral
31.
Sun M, Wang Y, Sundquist J, Sundquist K, Ji J. The Association Between Cancer and Dementia: A National Cohort Study in Sweden. Front Oncol. 2020;10:73.PubMedPubMedCentral
32.
van Dam FS, Schagen SB, Muller MJ, Boogerd W, vd Wall E, Droogleever Fortuyn ME, Rodenhuis S. Impairment of cognitive function in women receiving adjuvant treatment for high-risk breast cancer: high-dose versus standard-dose chemotherapy. J Natl Cancer Inst. 1998;90:210–218.PubMed
33.
Brezden CB, Phillips KA, Abdolell M, Bunston T, Tannock IF. Cognitive function in breast cancer patients receiving adjuvant chemotherapy. J Clin Oncol. 2000;18:2695–2701.PubMed
34.
Wefel JS, Lenzi R, Theriault RL, Davis RN, Meyers CA. The cognitive sequelae of standard-dose adjuvant chemotherapy in women with breast carcinoma: results of a prospective, randomized, longitudinal trial. Cancer. 2004;100:2292–2299.PubMed
35.
Schagen SB, van Dam FS, Muller MJ, Boogerd W, Lindeboom J, Bruning PF. Cognitive deficits after postoperative adjuvant chemotherapy for breast carcinoma. Cancer. 1999;85:640–650.PubMed
36.
Hurria A, Rosen C, Hudis C, Zuckerman E, Panageas KS, Lachs MS, Witmer M, van Gorp WG, Fornier M, D’Andrea G, Moasser M, Dang C, Van Poznak C, Hurria A, Holland J. Cognitive function of older patients receiving adjuvant chemotherapy for breast cancer: a pilot prospective longitudinal study. J Am Geriatr Soc. 2006;54:925–931.PubMed
37.
Kreukels BP, van Dam FS, Ridderinkhof KR, Boogerd W, Schagen SB. Persistent neurocognitive problems after adjuvant chemotherapy for breast cancer. Clin Breast Cancer. 2008;8:80–87.PubMed
38.
Heck JE, Albert SM, Franco R, Gorin SS. Patterns of dementia diagnosis in surveillance, epidemiology, and end results breast cancer survivors who use chemotherapy. J Am Geriatr Soc. 2008;56:1687–1692.PubMed
39.
Nead KT, Gaskin G, Chester C, Swisher-McClure S, Leeper NJ, Shah NH. Association Between Androgen Deprivation Therapy and Risk of Dementia. JAMA Oncol. 2017;3(1):49–55.PubMed
40.
Nead KT, Sinha S, Nguyen PL. Androgen deprivation therapy for prostate cancer and dementia risk: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis. 2017;20(3):259–264.PubMed
41.
Jayadevappa R, Chhatre S, Malkowicz SB, Parikh RB, Guzzo T, Wein AJ. Association Between Androgen Deprivation Therapy Use and Diagnosis of Dementia in Men With Prostate Cancer. JAMA Netw Open. 2019;2(7):e196562.PubMedPubMedCentral
42.
Krasnova A, Epstein M, Marchese M, Dickerman BA, Cole AP, Lipsitz SR, Nguyen PL, Kibel AS, Choueiri TK, Basaria S, Mucci LA, Sun M, Trinh QD. Risk of dementia following androgen deprivation therapy for treatment of prostate cancer. Prostate Cancer Prostatic Dis. 2020;23(3):410–418.PubMed
43.
Országhová Z, Mego M, Chovanec M. Long-Term Cognitive Dysfunction in Cancer Survivors. Front Mol Biosci. 2021;8:770413.PubMedPubMedCentral
44.
Achard V, Ceyzériat K, Tournier BB, Frisoni GB, Garibotto V, Zilli T. Biomarkers to Evaluate Androgen Deprivation Therapy for Prostate Cancer and Risk of Alzheimer’s Disease and Neurodegeneration: Old Drugs, New Concerns. Front Oncol. 2021;11:734881.PubMedPubMedCentral
45.
Lonergan PE, Washington SL 3rd, Cowan JE, Zhao S, Broering JM, Cooperberg MR, Carroll PR. Androgen Deprivation Therapy and the Risk of Dementia after Treatment for Prostate Cancer. J Urol. 2022;207(4):832–840.PubMed
46.
47.
Baik SH, Kury FSP, McDonald CJ. Risk of Alzheimer’s Disease Among Senior Medicare Beneficiaries Treated With Androgen Deprivation Therapy for Prostate Cancer. J Clin Oncol. 2017;35(30):3401–3409.PubMedPubMedCentral
48.
Nead KT. Androgen Deprivation Therapy and Dementia: New Opportunities and Challenges in the Big-Data Era. J Clin Oncol. 2017;35(30):3380–3381.PubMed
49.
Kim YA, Kim SH, Joung JY, Yang MS, Back JH, Kim SH. The Insignificant Correlation between Androgen Deprivation Therapy and Incidence of Dementia Using an Extension Survival Cox Hazard Model and Propensity-Score Matching Analysis in a Retrospective, Population-Based Prostate Cancer Registry. Cancers (Basel). 2022;14(11):2705.PubMed
50.
Liu JM, Shen CY, Lau WCY, Shao SC, Man KKC, Hsu RJ, Wu CT, Lai EC. Association between Androgen Deprivation Therapy and Risk of Dementia in Men with Prostate Cancer. Cancers (Basel). 2021;13(15):3861.PubMed
51.
Robinson D, Garmo H, Van Hemelrijck M, Damber JE, Bratt O, Holmberg L, Wahlund LO, Stattin P, Adolfsson J. Androgen deprivation therapy for prostate cancer and risk of dementia. BJU Int. 2019;124(1):87–92.PubMedPubMedCentral
52.
53.
54.
Du XL, Xia R, Hardy D. Relationship between chemotherapy use and cognitive impairments in older women with breast cancer: findings from a large population-based cohort. Am J Clin Oncol. 2010;33(6):533–43.PubMed
55.
Du XL, Cai Y, Symanski E. Association between chemotherapy and cognitive impairments in a large cohort of patients with colorectal cancer. Int J Oncol. 2013;42(6):2123–33.PubMed
56.
SAS Institute Inc (2012) Statistical Analysis with SAS/STAT® Software Cary, NC: SAS Institute Inc.
57.
Fine JP, Gray RJ. A Proportional Hazards Model for the Subdistribution of a Competing Risk. J Am Stat Assoc. 1999;94:496–509.
58.
Taylor DH Jr, Østbye T, Langa KM, Weir D, Plassman BL. The accuracy of Medicare claims as an epidemiological tool: the case of dementia revisited. J Alzheimers Dis. 2009;17:807–815.PubMedPubMedCentral
59.
Lee E, Gatz M, Tseng C, Schneider LS, Pawluczyk S, Wu AH, Deapen D. Evaluation of Medicare Claims Data as a Tool to Identify Dementia. J Alzheimers Dis. 2019;67:769–778.PubMedPubMedCentral
60.
Shariff SZ, Cuerden MS, Jain AK, Garg AX. The secret of immortal time bias in epidemiologic studies. J Am Soc Nephrol. 2008;19(5):841–3.PubMed
Metadata
Title
A Large Retrospective Cohort Study on the Risk of Alzheimer’s Disease and Related Dementias in Association with Vascular Diseases and Cancer Therapy in Men with Prostate Cancer
Authors
Xianglin L. Du
L. Song
Publication date
01-04-2023

Other articles of this Issue 2/2023

The Journal of Prevention of Alzheimer's Disease 2/2023 Go to the issue

Original Research

Cross-Sectional and Longitudinal Comparison of Tau Imaging with 18F-MK6240 and 18F-Flortaucipir in Populations Matched for Age, MMSE and Brain Beta-Amyloid Burden

Original Research

Predictive Utility of Plasma Amyloid and Tau for Cognitive Decline in Cognitively Normal Adults

Original Research

Medical Journey of Patients with Mild Cognitive Impairment and Mild Alzheimer’s Disease Dementia: A Cross-sectional Survey of Patients, Care Partners, and Neurologists

Brief Report

Predicting Progression from Normal to MCI and from MCI to AD Using Clinical Variables in the National Alzheimer’s Coordinating Center Uniform Data Set Version 3: Application of Machine Learning Models and a Probability Calculator

Review

Environmental Enrichment in Murine Models and Its Translation to Human Factors Improving Conditions in Alzheimer Disease

Original Research

Exploring the Associations between Alzheimer’s Disease and GBM Mediated by Microglia Based on Network Analysis

Advances in Alzheimer's

Alzheimer's research and care is changing rapidly. Keep up with the latest developments from key international conferences, together with expert insights on how to integrate these advances into practice.

This content is intended for healthcare professionals outside of the UK.

Supported by:
  • Lilly
Developed by: Springer Healthcare IME
Learn more
Image Credits