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. 2025 Jul 2;15(1):23490.
doi: 10.1038/s41598-025-08279-6.

Risk of Alzheimer's disease and Parkinson's disease following androgen deprivation therapy in a real world nationwide cohort

Ha-Lim Jeon  1 , Eunjung Choo  2   3 , Seung-Hwan Jeong  4   5 , Jiwoo Yun  3 , Chang Wook Jeong  6   7 , Hankil Lee  8
Affiliations

Risk of Alzheimer's disease and Parkinson's disease following androgen deprivation therapy in a real world nationwide cohort

Ha-Lim Jeon et al. Sci Rep. .

Abstract

The association between androgen deprivation therapy (ADT) and dementia including Alzheimer's disease remains debatable. Moreover, the evidence regarding the risk of vascular dementia and Parkinson's disease associated with ADT is limited. A population-based cohort study was conducted using the national health insurance data (2012-2022) from South Korea. Eligible patients newly diagnosed with prostate cancer who underwent ADT were compared with those who did not receive ADT. We applied propensity score matching and performed Cox proportional hazards regression analysis to calculate the adjusted hazard ratios (aHR) and 95% confidence intervals (CI). Of 163,723 patients with prostate cancer between 2013 and 2017, 24,456 were eligible. After 1:1 propensity score matching, 10,168 patients were included in each group. The risk of overall dementia was not significantly higher in ADT users compared with that of non-users (aHR = 1.07; 95% CI: 0.97-1.19); however, the elevated risk of Alzheimer's disease was observed (aHR = 1.39; 95% CI: 1.21-1.59). ADT was not associated with the risk of vascular dementia (aHR = 1.14; 95% CI: 0.70-1.94) and Parkinson's disease (aHR = 1.01; 95% CI: 0.75-1.35). Our updated evidence reinforces previous findings, indicating a positive association between ADT and the risk of Alzheimer's disease. However, it is unlikely that ADT increases the risk of vascular dementia and Parkinson's disease.

Keywords: Alzheimer’s disease; Androgen deprivation therapy; Dementia; Parkinson’s disease; Prostate cancer.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was approved by the Institutional Review Board of Ajou University (202305-HB-EX-001), which waived the requirement for informed consent as only de-identified data were used. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart for the selection of study population.
Fig. 2
Fig. 2
Kaplan-Meier curves for overall dementia, Alzheimer’s disease, vascular dementia, and Parkinson’s disease. ADT, Androgen deprivation therapy.
Fig. 3
Fig. 3
Forest plot for results from the subgroup analyses stratified by age, metastatic status, occurrence of fracture, use of anticholinergics, and use of imipramine/duloxetine.
See this image and copyright information in PMC

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