Risk factors for cognitive dysfunction in prostate cancer patients undergoing androgen deprivation therapy: a retrospective study

OBJECTIVE: To evaluate the clinical efficacy of endocrine therapy for prostate cancer and analyze risk factors for treatment-related cognitive dysfunction. METHODS: A retrospective study was conducted involving 100 prostate cancer patients receiving endocrine therapy and 100 non-recipients. Quality of life, urinary symptoms, and cognitive function were assessed. Patients were categorized into cognitive dysfunction (n=38) and non-dysfunction (n=62) groups based on post-treatment assessment. Univariate and multivariate analyses were used to identify influencing factors, and a predictive model was developed. RESULTS: The endocrine therapy group showed significantly better quality of life and urinary symptom scores (all P < 0.05), though the 5-year survival rate was lower than that of the control group (72.4% vs 82.7%). Cognitive impairment incidence was 38%. Risk factors included older age, lower education, lower Montreal Cognitive Assessment (MoCA) scores, and higher Prostate-Specific Antigen (PSA), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) scores (all P < 0.05). Multivariate analysis confirmed MoCA, age, SAS, and SDS as independent predictors. The predictive model demonstrated high discriminative ability (AUC=0.903). CONCLUSION: Endocrine therapy improves quality of life and urinary symptoms in prostate cancer patients but is associated with cognitive dysfunction. A model incorporating MoCA, age, and psychological scores effectively predicts cognitive impairment risk, enabling targeted intervention.