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Review
. 2024 May 17:14:33-46.
doi: 10.2147/DNND.S445130. eCollection 2024.

A Comprehensive Review and Androgen Deprivation Therapy and Its Impact on Alzheimer's Disease Risk in Older Men with Prostate Cancer

Manisha Singh #  1   2   3 , Vinayak Agarwal #  3   4 , Pranav Pancham  3   5 , Divya Jindal  3   6 , Shriya Agarwal  3   7 , Sachchida Nand Rai  8 , Santosh Kumar Singh  8 , Vivek Gupta  9
Affiliations
Review

A Comprehensive Review and Androgen Deprivation Therapy and Its Impact on Alzheimer's Disease Risk in Older Men with Prostate Cancer

Manisha Singh et al. Degener Neurol Neuromuscul Dis. .

Abstract

Prostate cancer (PCa) is one of the most prevalent malignancies affecting males worldwide. Despite reductions in mortality rates due to advances in early identification and treatment methods, PCa remains a major health concern. Recent research has shed light on a possible link between PCa and Alzheimer's disease (AD), which is a significant neurological ailment that affects older males all over the world. Androgen deprivation therapy (ADT), a cornerstone therapeutic method used in conjunction with radiation and palliative care in advanced metastatic PCa cases, is critical for disease management. Evidence reveals a relationship between ADT and cognitive impairment. Hormonal manipulation may cause long-term cognitive problems through processes such as amyloid beta (Aβ) aggregation and neurofibrillary tangles (NFTs). Fluctuations in basal androgen levels can upset the delicate balance of genes that are sensitive to androgen levels, contributing to cognitive impairment. This detailed review dives into the various aspects of PCa aetiology and its relationship with cognitive decline. It investigates the discovery of particular biomarkers, as well as microRNAs (miRNAs), which play important roles in pathogenic progression. The review attempts to identify potential biomarkers associated with ADT-induced cerebral changes, including Aβ oligomer buildup, NFT formation, and tauopathy, which can contribute to early-onset dementia and cognitive impairment. Besides it further aims to provide insights into innovative diagnostic and therapeutic avenues for alleviating PCa and ADT-related cognitive sequelae by unravelling these complicated pathways and molecular mechanisms.

Keywords: androgen; cognitive defects; dementia; metastatic cancer; testosterone.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
The diagrammatic representation of factors responsible for the pathophysiological progression of prostate cancer.
Figure 2
Figure 2
Sequential progression of prostate cancer pathogenesis and the intersection of ADT in the pathology.
Figure 3
Figure 3
Schematic representation showcasing the consequences of taking Androgen-deprived therapy that led to the onset of cognitive decline (dementia).
See this image and copyright information in PMC

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