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Cited by 21Cancer-related cognitive impairment studiesDementia and Cognitive Impairment ResearchIntensive Care Unit Cognitive Disorders

Chemotherapy and the Risk of Alzheimer's Disease in Colorectal Cancer Survivors: Evidence From the Medicare System

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Akushevich, Igor, Yashkin, Arseniy P., Kravchenko, Julia, Kertai, Miklos D.·2021·JCO Oncology Practice
DOI 10.1200/op.20.00729PMC PMC8600506
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Abstract

PURPOSE: Evidence on the nature of the relationship between patients receiving chemotherapy as an essential part of guideline-concordant cancer care and the onset of Alzheimer's Disease (AD) and other adverse cognitive outcomes has been mixed. Biological mechanisms were proposed to support both a potentially beneficial and an adverse role. To explore the relationship between chemotherapy and onset of AD and other neurocognitive disorders (ND) in colorectal cancer survivors. METHODS: We conducted a retrospective cohort study of 135,834 individuals older than 65 years diagnosed with colorectal cancer between 1998 and 2007, using SEER-Medicare data. A proportional hazards model was used before and after the use of inverse probability weighting to account for populational differences between the chemotherapy and nonchemotherapy groups. Weights were normalized to the total sample size. RESULTS: After inverse probability weighting, chemotherapy was associated with decreased AD risk (hazard ratio [HR]: 0.791; 95% CI: 0.758 to 0.824) and lower risk for the majority of other ND including AD-related diseases (HR: 0.823; CI: 0.802 to 0.844), dementia (permanent mental disorder) (HR: 0.807; CI: 0.782 to 0.832), and dementia (senile) (HR: 0.772; CI: 0.745 to 0.801). The only adverse effect to remain significant was cerebral degeneration (excluding AD) (HR: 1.067; CI: 1.033 to 1.102). The effects for AD remained after treatment was stratified by chemotherapy agent type and remained significant for up to 6 years past diagnosis. CONCLUSION: Chemotherapy use in colorectal cancer survivors demonstrated an association with reduced risk for AD and other ND.

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Cited by

Sorted by citations

Authors
Akushevich, I., Yashkin, A. P., Kravchenko, J., & Kertai, M. D.
Affiliations
  • Duke University (US)
  • Vanderbilt University Medical Center (US)
ORCID
Venue
JCO Oncology Practice
Publisher
American Society of Clinical Oncology (ASCO)
Published
2021-11
Volume
17
Issue
11
Pages
e1649-e1659
ISSN
  • 2688-1527 (ISSN-L)
  • 2688-1535
DOI
10.1200/op.20.00729
PMC
PMC8600506
OpenAlex
W3129916945
Cited by
21
References
1
Citations by year
2026: 2 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 3 · 2021: 2
FWCI
2.24
Type
journal article
Language
en
Open access
Locations
  • JCO Oncology Practice (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Aging (RF1AG046860, R01AG066133, R01AG057801)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
Keywords
chemotherapy, Alzheimer's disease, colorectal cancer survivors, neurocognitive disorders, dementia, cerebral degeneration, cancer survivorship, cognitive outcomes
MeSH terms
Aged, Alzheimer Disease, Medicare, Humans, Retrospective Studies, United States, Colorectal Neoplasms, Survivors

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