Abstract：
BACKGROUND: Hormone therapy, which is widely prescribed for prostate cancer, might induce cognitive impairment and affect the autonomy of elderly patients. However, previous studies provided conflicting results. The aim of this systematic review and meta-analysis was to synthesize the longitudinal impact of hormone therapy on objective (cognitive tests) and subjective (questionnaires) cognition.
METHODS: A search was performed of the PubMed, Web of Science, and PsycINFO databases. Studies that longitudinally assessed cognition in patients undergoing androgen-deprivation therapy and new-generation hormone therapy were considered. To perform a meta-analysis, available scores were aggregated and classified into six objective domains and one subjective domain. Weighted mean effect sizes were computed using a random effect model.
RESULTS: Twenty studies were included in the systematic review (1440 patients), and 15 could be included in the meta-analysis (1093 patients). In the systematic review, 20%-50% of patients had objective cognitive impairment before treatment initiation. The meta-analysis revealed a decline in subjective cognition (g = -0.44; p = .03) with androgen-deprivation therapy and new-generation hormone therapy. All other effect sizes were small (from g = -0.02 to g = 0.18), and none of them indicated a significant decline in objective cognition. Significant heterogeneity was observed in all domains of objective cognition.
CONCLUSIONS: This synthesis presents the first meta-analytic evidence of the negative impact of androgen-deprivation therapy and new-generation hormone therapy on subjective cognition. In contrast, there was no conclusive evidence of a decline in objective cognition. The high heterogeneity underscores the need for homogeneous cognitive research on prostate cancer.
CONCLUSIONS: There is no consensus on the cognitive impairment induced by hormone therapy for prostate cancer, despite the implications for patients\' care and daily life. This synthesis of published studies demonstrated an increase in perceived cognitive difficulties but did not prove a decline in cognitive performance during treatment.
METHODS: A search was performed of the PubMed, Web of Science, and PsycINFO databases. Studies that longitudinally assessed cognition in patients undergoing androgen-deprivation therapy and new-generation hormone therapy were considered. To perform a meta-analysis, available scores were aggregated and classified into six objective domains and one subjective domain. Weighted mean effect sizes were computed using a random effect model.
RESULTS: Twenty studies were included in the systematic review (1440 patients), and 15 could be included in the meta-analysis (1093 patients). In the systematic review, 20%-50% of patients had objective cognitive impairment before treatment initiation. The meta-analysis revealed a decline in subjective cognition (g = -0.44; p = .03) with androgen-deprivation therapy and new-generation hormone therapy. All other effect sizes were small (from g = -0.02 to g = 0.18), and none of them indicated a significant decline in objective cognition. Significant heterogeneity was observed in all domains of objective cognition.
CONCLUSIONS: This synthesis presents the first meta-analytic evidence of the negative impact of androgen-deprivation therapy and new-generation hormone therapy on subjective cognition. In contrast, there was no conclusive evidence of a decline in objective cognition. The high heterogeneity underscores the need for homogeneous cognitive research on prostate cancer.
CONCLUSIONS: There is no consensus on the cognitive impairment induced by hormone therapy for prostate cancer, despite the implications for patients\' care and daily life. This synthesis of published studies demonstrated an increase in perceived cognitive difficulties but did not prove a decline in cognitive performance during treatment.
摘要：
背景：激素治疗，广泛用于前列腺癌，可能诱发认知功能损害,影响老年患者的自主性。然而,以往的研究提供了相互矛盾的结果.本系统综述和荟萃分析的目的是综合激素治疗对客观（认知测试）和主观（问卷调查）认知的纵向影响。
方法：对PubMed进行了搜索，WebofScience,和PsycINFO数据库。考虑了纵向评估接受雄激素剥夺治疗和新一代激素治疗的患者认知的研究。要进行荟萃分析，对可用评分进行汇总,分为6个客观领域和1个主观领域.使用随机效应模型计算加权平均效应大小。
结果：20项研究纳入系统评价（1440例患者），15例患者可纳入荟萃分析(1093例患者).在系统审查中，20％-50％的患者在治疗开始前存在客观认知障碍。荟萃分析显示，雄激素剥夺疗法和新一代激素疗法的主观认知下降（g=-0.44；p=0.03）。所有其他效应大小都很小（从g=-0.02到g=0.18），没有一个表明客观认知显著下降。在客观认知的所有领域均观察到显着的异质性。
结论：本综述提供了第一个meta分析证据，证明雄激素剥夺治疗和新一代激素治疗对主观认知的负面影响。相比之下,没有确凿的证据表明客观认知能力下降.高度异质性强调了对前列腺癌进行同质认知研究的必要性。
结论：关于激素治疗前列腺癌引起的认知障碍尚无共识，尽管对患者的护理和日常生活有影响。这项已发表研究的综合研究表明，感知的认知困难有所增加，但并未证明治疗期间认知能力下降。
方法：对PubMed进行了搜索，WebofScience,和PsycINFO数据库。考虑了纵向评估接受雄激素剥夺治疗和新一代激素治疗的患者认知的研究。要进行荟萃分析，对可用评分进行汇总,分为6个客观领域和1个主观领域.使用随机效应模型计算加权平均效应大小。
结果：20项研究纳入系统评价（1440例患者），15例患者可纳入荟萃分析(1093例患者).在系统审查中，20％-50％的患者在治疗开始前存在客观认知障碍。荟萃分析显示，雄激素剥夺疗法和新一代激素疗法的主观认知下降（g=-0.44；p=0.03）。所有其他效应大小都很小（从g=-0.02到g=0.18），没有一个表明客观认知显著下降。在客观认知的所有领域均观察到显着的异质性。
结论：本综述提供了第一个meta分析证据，证明雄激素剥夺治疗和新一代激素治疗对主观认知的负面影响。相比之下,没有确凿的证据表明客观认知能力下降.高度异质性强调了对前列腺癌进行同质认知研究的必要性。
结论：关于激素治疗前列腺癌引起的认知障碍尚无共识，尽管对患者的护理和日常生活有影响。这项已发表研究的综合研究表明，感知的认知困难有所增加，但并未证明治疗期间认知能力下降。
