Estrogen‐modulating breast cancer therapies and the incidence of Alzheimer's disease: Epidemiology / Risk and protective factors in MCI and dementia. (7th December 2020)

• Record Type: Journal Article
• Authors: Branigan, Gregory L; Soto, Maira; Neumayer, Leigh; Rodgers, Kathleen E; Brinton, Roberta Diaz
• Is Part Of: Alzheimer's & dementia. Volume 16(2020)Supplement 10
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-12-07
• Subjects: Alzheimer's disease -- Periodicals; Alzheimer Disease -- Periodicals; Dementia -- Periodicals; Démence; Maladie d'Alzheimer; Périodique électronique (Descripteur de forme); Ressource Internet (Descripteur de forme); 616.83
• DOI: 10.1002/alz.043890
• Languages: English
• ISSNs: 1552-5260

Abstract

Abstract: Background: Globally, neurological disorders rank as the leading cause of disability‐adjusted life‐years, and the second‐leading cause of deaths. The high global prevalence and economic impact of Alzheimer's disease presents a significant public health challenge while the identification of therapies to prevent Alzheimer's disease (AD) remains a challenge. Worldwide, breast cancer is the most common non‐skin cancer in women. Approximately 1 in 8 women will be diagnosed with breast cancer during their lifetime. Currently, Alzheimer's disease affects 1 in 9 persons in the US over the age of 65, two thirds of whom are women. Method: The objective of this study was to determine whether exposure to hormone modulating therapies targeting estrogen for the treatment of breast cancer impact the risk of AD using medical informatics and the Symphony claims data set. The Symphony data set contains claims from private‐payer and Medicare insurance data sets from across the United States. Survival analysis was used to determine the association between estrogen modulating therapy exposure and diagnosis of AD in the post index date follow‐up period. A propensity score approach was used to minimize measured and unmeasured selection bias. Result: In this cohort study of propensity score matched perimenopausal to postmenopausal aged women with breast cancer, estrogen modulating therapy exposure was associated with decrease in diagnosis of neurodegenerative disease, most specifically Alzheimer's disease. Kaplan‐Meier curves for AD‐free survival were analyzed to measure the overall rate and proportion of patients in each treatment group who went on to develop neurodegenerative disease. Conclusion: Among female patients with breast cancer, exposure to estrogen modulating therapies, specifically tamoxifen and steroidal aromatase inhibitors, was associated with a decrease in diagnosis of AD and Dementia. As a result, translational studies investigating the mechanisms by which these therapeutics impact AD risk are currently underway.