***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: And rogen deprivation ( AD ) is commonly used in neoadjuvant and adjuvant setting with prostate cancer ( PC ) radiotherapy . This prospect i ve study assessed whether cognitive functioning is impaired during 12 months of AD therapy . Longitudinal testing of 25 patients treated with AD and curative radiotherapy  was undertaken at baseline , and at 6 and 12 months . CogniSpeed © software was used for measuring attentional performances . Other cognitive performances were evaluated using verbal , visuomotor and memory tests . The Beck depression inventory was employed to evaluate depressive mood and EORTC QLQ-C30 for quality of life ( QoL ) . During longitudinal testing of the AD group , no impairment in cognitive performances was found . Instead , improvement was observed in object recall ( immediate , P=0.035 ; delayed , P<0.001 ) , and in semantic memory ( P=0.037 ) . In QoL , impairment in physical function was observed . And rogen deprivation of 12 months appears to be associated with preserved cognitive functioning , although physical impairment occurs . These results have implication s for counseling and psychosocial support of patients in the context of treatment options in PC OBJECTIVE To examine , in a prospect i ve study , the influence that temporary reversible medical castration for localized prostate cancer has on cognition , by assessing whether temporary 3 - 5 month treatment with a luteinizing-hormone releasing hormone ( LHRH ) agonist before radical radiotherapy had a short- or long-term affect on cognitive function . PATIENTS , SUBJECTS AND METHODS Thirty-two patients with localized prostate cancer had  cognitive assessment  s at baseline ( T1 ) before the start of drug treatment , at 3 months ( T2 ) or on completing drug treatment but before radiotherapy , and 9 months later ( T3 ) . Eighteen men with no prostate cancer ( controls subjects ) completed the  cognitive tests  at the same times . In addition , psychological functioning and quality of life were assessed at the same times , together with serum free and bound testosterone , beta-oestradiol and sex hormone-binding globulin levels . RESULTS There was a significant cognitive decline ( on at least one cognitive task ) at T2 in 15 ( 47 % ) patients vs three ( 17 % ) of controls ( odds ratio 4.412 , P = 0.033 ) . Most patients ( nine of 15 ) who had a change in performance declined on tasks of spatial memory and ability . At T3 there was significant cognitive decline in 11 ( 34 % ) patients and five ( 28 % ) control subjects ( odds ratio 1.37 , P = 0.631 ) . CONCLUSION This pilot study suggests that short-term LHRH therapy for early-stage prostate cancer has modest short-term consequences on men 's cognitive functioning ; a larger prospect i ve study is warranted PURPOSE Men with prostate specific antigen ( PSA ) only relapse of prostate cancer after primary therapy are generally fully functional and asymptomatic with a life expectancy of up to 10 or more years . These patients are often treated with and rogen suppression . We evaluate the effects of and rogen suppression on cognitive function . MATERIAL S AND METHODS Hormone naïve patients without evidence of metastases with an increasing PSA were treated with intermittent and rogen suppression consisting of 9 months of leuprolide and flutamide followed by an off treatment period determined by the increase in PSA .  Cognitive function tests were administered at baseline , after 9 months of and rogen suppression and after 3 months off treatment . Cognitive tests measured spatial abilities , spatial memory , verbal fluency , verbal memory and selective attention .  A total of 19 patients 52 to 76 years old completed the intermittent and rogen suppression study along with 15 healthy community dwelling control participants . RESULTS Combined and rogen blockade reduced PSA and testosterone in all patients compared to baseline . Patients did not significantly change on measures of verbal and spatial memory , executive functions or language . Patients declined on a measure of spatial rotation and improved on a measure of verbal memory during treatment which continued during the off treatment period . CONCLUSIONS Although preliminary , these findings demonstrate that 9 months of combined and rogen blockade result ed in a beneficial effect on verbal memory but adversely affected a measure of spatial ability .  Intermittent and rogen suppression for a period of 9 months in otherwise healthy men with prostate cancer may have beneficial and adverse effects on cognition that are selective Objective To report the first systematic investigation of the cognitive effects of luteinizing hormone‐releasing hormone ( LHRH ) analogues in male patients , as LHRH analogues have been associated with memory impairments in women using these drugs for gynaecological conditions The adverse effects of hormonal manipulation in prostate carcinoma need to be established in view of its increasing use as an adjuvant treatment . This prospect i ve study investigated the association of  and rogen deprivation‐induced estradiol  decline with cognition in prostate carcinoma OBJECTIVE To determine the baseline prevalence of cognitive impairment in older men treated with ADT and to assess changes in cognitive performance over time . METHODS AND RESULTS Thirty-two patients ( median age of 71 years , range 51 - 87 ) were administrated an extensive neuropsychological testing battery prior to ADT initiation , with 21 ( 65 % ) completing post-treatment evaluations 6 months later . At baseline , 45 % scored > 1.5 st and ard deviations below the mean on > or = 2 neuropsychological measures . Using st and ardized inferential statistics , no change in cognition was documented following treatment . The Reliable Change Index revealed that , on a case-by-case basis , 38 % demonstrated a decline in measures of executive functioning and 48 % showed improvement on measures of visuospatial abilities . Within exploratory analyses , patients who scored below expectation at baseline displayed no change in cognition , while patients with average or better scores at baseline displayed improvements in visuospatial planning and timed tests of phonemic fluency . CONCLUSIONS We found a high prevalence of lower than expected cognitive performance among a sample of patients just starting ADT for prostate cancer . Assessment of baseline cognitive function should be taken into account for future research and to inform clinical management The results of several recent studies suggest that estrogen and testosterone play an important role in the modulation of mood and cognitive function in women , and preliminary evidence indicates that these hormones may also modulate the levels of beta-amyloid ( Abeta ) , a 4 Kilo Dalton peptide that is likely to be involved in the pathogenesis of Alzheimer 's disease . However , the physiological and clinical effects of reversible castration remain unclear and no systematic data is currently available for men . We design ed the present study to investigate the effects of reversible chemical castration on the mood and cognitive performance of men treated for prostate cancer , as well as its impact on the levels of plasma Abeta .  Forty men with prostate cancer were clinical ly treated with  and rogen blockade therapy ( flutamide and leuprolide ) for 36 weeks and subsequently followed up for another 18 weeks after treatment was discontinued . All subjects received a comprehensive clinical , neuropsychological and biochemical evaluation that included the use of the Beck Depression ( BDI ) and Anxiety Inventories ( BAI ) , several subtests of the Wechsler Memory and Intelligence Scales ( Word Lists-WL , Verbal Paired Associates-VPA , Visual Reproduction-VR and Block Design -BD ) , and biochemical monitoring of changes in estrogen , testosterone and Abeta levels . Chemical castration was associated with a rapid and marked decline in the levels of testosterone and estradiol , and significant increase in plasma Abeta levels . Treatment was associated with increased BDI ( p = 0.004 ) and BAI scores ( p < 0.001 ) , although such changes were of question able clinical significance ( i.e. , few subjects had scores > or = 13 ) . CAMCOG ( p = 0.046 ) and WL recall total scores ( p < 0.001 ) improved significantly after and rogen blockade treatment was discontinued , but visuospatial abilities , as assessed by BD , was not influenced by the introduction or discontinuation of treatment . There was a significant negative correlation between changes in Abeta levels and subjects ' WL total score change between weeks 36 and 54 ( r = -0.452 , p = 0.012 ) . The results of this naturalistic study indicate that chemical castration is associated with a significant rise in the plasma levels of Abeta and , clinical ly , with increased depression and anxiety scores . The discontinuation of treatment is associated with better cognitive performance , most noticeably of verbal memory . The performance of subjects on the WL test was negatively correlated with plasma levels of Abeta , but the clinical significance of this finding remains to be determined OBJECTIVE And rogen deprivation therapy ( ADT ) remains a widely utilized modality for treatment of localized and advanced prostate cancer . While ADT-induced alterations in testosterone have demonstrated impacts on quality of life , the effects on mental health remain ill-defined . We investigated the prevalence of de novo psychiatric illness and predictive factors following ADT induction for prostate cancer . MATERIAL S AND METHODS We retrospectively review ed patients receiving ADT for prostate cancer at our institution between 1/1989 - 7/2005 , excluding men receiving only neoadjuvant ADT .  Variables included age , race , body mass index , prostate-specific antigen ( PSA ) , Gleason sum , clinical stage , ADT type ( medical/surgical ) and schedule ( continuous/intermittent ) , and presence of pre-ADT and newly diagnosed psychiatric illness . The cohort was divided into three groups for analysis : pre-ADT psychiatric illness , de novo psychiatric illness , and no psychiatric illness . Data analysis utilized statistical software with p < 0.05 considered significant . RESULTS Three-hundred and ninety-five patients with a mean age of 71.7 years at ADT initiation were analyzed . Thirty-four men ( 8.6 % ) were diagnosed with pre-ADT psychiatric illness .  At mean follow-up of 87.4 months , 101 ( 27.9 % ) men were diagnosed with de novo psychiatric illness , most commonly including : depression ( n = 57 ; 56.4 % ) , dementia ( n = 14 ; 13.9 % ) , and anxiety ( n = 9 ; 8.9 % ) . On multivariate analysis , increasing pre-ADT PSA was predictive of post-ADT anxiety ( p = 0.01 ) . Overall and disease-specific survival outcomes were similar between groups . CONCLUSIONS De novo psychiatric illness was identified in 27.9 % of men . While no predictive factors were identified for de novo psychiatric illness , increasing PSA was associated with de novo anxiety . Prospect i ve investigation using vali date d instruments is requisite to further delineate the relationship between ADT and psychiatric health 
    Output:
    
Cognitive domains impaired by ADT included : verbal memory , visuospatial ability and executive functions .
A variety of measures and methods were used to assess cognitive function including neuropsychological tests , self‐report measures and clinical assessment s. The finding that , often , one measure was used to assess more than one aspect of cognition is likely to have contributed to imprecise estimates .