Breast cancer survivors may have a lower risk of Alzheimer’s dementia

1. In this retrospective cohort study, breast cancer survivors had a lower risk of Alzheimer’s dementia compared with cancer-free controls. 

2. Radiation therapy was associated with a significantly decreased risk of AD development among breast cancer survivors. 

Evidence Rating Level: 2 (Good)

Breast cancer is the most common cancer affecting women worldwide, with advances in treatment increasing survival rates to above 93% for early-stage disease. With this increase in survival, there has been an emerging focus on quality of life and long-term health consequences, including cognitive decline. Many survivors have reported cognitive difficulties; however, the relationship between breast cancer and Alzheimer’s disease (AD) remains unclear. To address this knowledge gap, this retrospective cohort study used a Korean national database to examine the association between breast cancer, its treatment and AD risk. The main outcome of this study was the development of a new AD diagnosis, defined as having at least one prescription for antidementia medications during the follow-up period. Among the cohort of 70,701 breast cancer survivors (mean [SD] age, 53.1 [8.5] years), 1,229 individuals were diagnosed with AD, corresponding to an incidence rate of 2.45 per 1,000 person years. During follow-up, there were 1,229 new cases among breast cancer survivors (incidence rate 2.45 per 1000 person-years), and 3430 new cases among cancer-free controls (incidence rate 2.63 per 1000 person-years). There was a lower risk of AD among the survivors than the controls (SHR, 0.92; 95% CI, 0.85-0.99); however, this decreased risk did not persist past 5 years. Radiation therapy was associated with the lowest risk of AD development (AHR, 0.77; 95% CI, 0.68-0.87) compared with other treatment modalities. In summary, this cohort of breast cancer survivors had a slightly lower risk of AD incidence compared to their respective cancer-free controls. The results of this study suggest that certain cancer treatments may be protective for AD, however, further research in this area is needed. 

Click to read the study in JAMA Network Open

Image: PD

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