Association between cancer treatment and progression of all‐cause dementia

Background Cancer treatments have been associated with cancer‐related cognitive impairment (CRCI). CRCI exhibits symptoms similar to those experienced with dementia syndromes, and could result from the cancer itself or as a consequence of cancer therapies. No studies have examined the potential effect of cancer treatments on cognition in dementia. Method Electronic health record data from the University of Alabama at Birmingham were extracted July 2003 to February 2020. Baseline cognition and cognitive progression on the Alabama Brief Cognitive screener (ABCs) among dementia patients based on receipt of various cancer treatments were evaluated using adjusted linear mixed effects models. Result Hormone therapies were associated with faster decline on the ABCs compared to other treatments (b: ‐1.39, 95% CI: ‐2.73, ‐0.04). Similar results were seen for hormone therapies compared to neither hormone nor immunotherapy (b: ‐1.55, 95% CI: ‐3.02, ‐0.08). No cognitive differences were detected for other cancer treatments. Conclusion Hormone therapies may lead to faster cognitive decline in cancer survivors who develop dementia later in life. Larger studies of long‐term effects of cancer therapies are needed to allow for stratification by cancer type and cancer staging and evaluate modification by race and socioeconomic status.