So, does ADT impair cognitive function or not?

Effects of a luteinizing hormone-releasing hormone agonist on cognitive, sexual, and hormonal functions in patients with prostate cancer: relationship with testicular and adrenal androgen levels. By Okamoto et al 2015 

 

Key sentence from the paper: “LH-RH agonist monotherapy worsended sexual and hormonal functions and hormonal bothers, but not sexual bothers or cognitive functions.”

 

For the full abstract, see: http://www.bacandrology.com/content/25/1/3

  

Commentary: This is a small study, with only 45 patients of an average age of 67.5 years. The study is nevertheless interesting in several regards. The authors used a standard clinical screening test for cognitive function, the Mini Mental State Evaluation (MMSE) test.  They found no significant impact of ADT on MMSE scores, but to their credit they recognized that this very brief test is not a rigorous instrument for identifying details of cognitive function. [They did suggest though that low estrogen was related to worse MMSE scores.]

The other parameters measured, such as sexual function and bother, plus impact of the ADT on hot flashes, breast tenderness, depression, energy levels, and body weight were, in general, in line with many other previous studies. 

One nice feature of this study is that the authors did a fairly comprehensive assessment of both gonadal and adrenal steroids. The results hint at the fact that cortisol, the classic stress hormone, may play a role in how burdened patients are by the side effects of ADT. The authors acknowledge that their study needs to be repeated in larger sample size and we agree.

 

Okamoto, K., Sekine, Y. Nomura, M., Koike, H., Matsui, H., Shibata, Y., Ito, K., and Suzuki, K. 2015. Effects of a luteinizing hormone-releasing hormone agonist on cognitive, sexual, and hormonal functions in patients with prostate cancer: relationship with testicular and adrenal androgen levels. Basic and Clinical Andrology 25:3.