The effect of androgen deprivation therapy (ADT) on cognition in men with prostate cancer
Bibliographic record
Abstract
14626 Background: ADT plays a central role in the management of prostate cancer. However, there is emerging evidence that ADT use may adversely affect cognition. Given the long natural history of prostate cancer and the elderly population it predominantly affects, this may be an important survivorship issue in this population. Methods: We performed a MEDLINE search of English-language literature from 1966 to December 2005 and identified eight prospective studies that evaluated the effect of ADT on cognition and one study that investigated the effect of therapy on the cognition of patients receiving ADT. Due to differences in study design and outcomes, studies could not be combined meta-analytically. Results: Studies were small, ranging from 19–82 patients. ADT was used in the neoadjuvant setting in 2 studies, a neoadjuvant or adjuvant setting in 1 study, and in a palliative setting for high-risk disease in 5 studies. Controls were featured in 4 studies. Follow-up ranged from 6 to 13 months. A variety of cognitive domains were assessed (using traditional and computer-based neuropsychological tasks). Whereas 4 studies found worsening in one or more domains in patients over time, 4 studies showed either no worsening or improvement in one or more cognitive domains after ADT was instituted. No cognitive domain was consistently affected by ADT. Three of the studies included follow-up 3 months after ADT was stopped and all 3 showed at least some improvement in cognitive function. Short-term supplementation with estradiol did not improve cognitive function in 1 study. There were fundamental differences across studies in terms of patient populations, cognitive domains tested and specific tests used, and type of ADT. Other important limitations included small sample sizes, limited follow-up, and practice effects. Conclusions: The impact of ADT on cognitive function and its potential reversibility are unclear, and further studies are needed. In the meantime, clinicians and patients should continue to carefully weigh the potential benefits and risks of ADT when making treatment decisions. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.014 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.007 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".