Cognitive effects of androgen deprivation therapy in an older cohort of men with prostate cancer.
Cognitive effects of androgen deprivation therapy in an older cohort of men with prostate cancer.
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DOI：
10.1016/j.critrevonc.2010.06.009
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发表时间：
2010-08
影响因子：
6.2
通讯作者：
Stadler, Walter M.
中科院分区：
文献类型：
--
作者：
Mohile, Supriya Gupta;Lacy, Maureen;Rodin, Miriam;Bylow, Kathryn;Dale, William;Meager, Michael R.;Stadler, Walter M.
确定接受ADT治疗的老年男性中认知功能障碍的基线患病率，并评估认知功能随时间的变化。32例患者（中位年龄71岁，范围51-87岁）在ADT开始前接受了广泛的神经心理学测试，其中21例（65%）在6个月后完成了治疗后评价。基线时，45%的患者在≥2项神经心理学指标上的得分低于平均值>1.5个标准差。使用标准化的推理统计，没有记录治疗后的认知变化。可靠变化指数显示，在个案基础上，38%的人表现出执行功能的下降，48%的人表现出视觉空间能力的改善。在探索性分析中，基线评分低于预期的患者在认知方面没有变化，而基线评分平均或更好的患者在视觉空间规划和音素流畅性定时测试方面有所改善。我们发现，在刚开始ADT治疗前列腺癌的患者样本中，认知表现低于预期的患病率很高。基线认知功能的评估应考虑到未来的研究和通知临床管理。
To determine the baseline prevalence of cognitive impairment in older men treated with ADT and to assess changes in cognitive performance over time. Thirty-two patients (median age of 71 years, range 51–87) were administrated an extensive neuropsychological testing battery prior to ADT initiation, with 21 (65%) completing post-treatment evaluations 6 months later. At baseline, 45% scored >1.5 standard deviations below the mean on ≥2 neuropsychological measures. Using standardized inferential statistics, no change in cognition was documented following treatment. The Reliable Change Index revealed that, on a case-by-case basis, 38% demonstrated a decline in measures of executive functioning and 48% showed improvement on measures of visuospatial abilities. Within exploratory analyses, patients who scored below expectation at baseline displayed no change in cognition, while patients with average or better scores at baseline displayed improvements in visuospatial planning and timed tests of phonemic fluency. We found a high prevalence of lower than expected cognitive performance among a sample of patients just starting ADT for prostate cancer. Assessment of baseline cognitive function should be taken into account for future research and to inform clinical management.
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