Prevalence of sarcopenic obesity in adult patients with diabetes and associated factors: a systematic review and meta-analysis.

Globally, prostate cancer is the second most common cancer among men () with rising incidence rates concomitant with an ageing population and improved screening (, ). Although the prognosis is favorable in most high-income countries, and the associated mortality rates have continued to fall since the mid 1990’s (), many men continue to experience severe side-effects from the cancer and associated treatments with little or no self-management advice (). Specifically, Androgen Deprivation Therapy (ADT) is commonly associated with distressing levels of fatigue (), coupled with a higher predisposition to cardiovascular disease, diabetes and depression (, ). Side-effects such as fatigue have successfully been the target of several intervention strategies including pharmacological aid and varying forms of physical activity (, ). Compared to other side-effects, cognitive disruptions related to prostate cancer and it’s treatment have received less attention in research, but include both objectively assessed deficits and subjective complaints (, ). The exact cause of these cognitive disruptions remain unclear, although ADT is often implicated (). For instance, ADT has been linked to structural (, ) and functional changes in the brain (). In addition, executive functioning has been shown to be impacted by ADT (, ) as well as verbal memory (, , ) attention (, ), processing speed (), visual processing () and spatial ability (). Indeed, there is evidence that the discontinuation of hormone therapy in men with prostate cancer is associated with better cognitive ability for verbal memory tasks (). Regardless of the specific cause of cognitive side-effects related to prostate cancer treatments, preventing and mitigating these side-effects requires more attention. Given the likely link between structural and functional brain pathways, as well as a higher level of cognition potentially mitigating excessive cognitive fatigue day to day, interventions that can promote improvement in these areas, like engaging in physical and cognitive activity, are well positioned to support men with prostate cancer in the future. There is good evidence to support the benefits of physical activity on cognitive function across the lifespan (, ), but related research in cancer is largely limited to breast cancer (, ). In prostate cancer, the limited evidence suggests that men who report greater levels of physical activity perform better on assessments of memory, attention and executive function (). Within intervention studies, a scarcity of evidence exists, although 8-weeks of combined aerobic and resistance exercise was found to be associated with improvements in self-reported cognitive function (). This initial evidence, while limited, aligns with findings in other populations and supports the potential for physical activity to benefit cognitive function in men with prostate cancer. As such, there is a clinical need for physical activity-based intervention studies with objective measures of cognitive function to inform the relative effectiveness of interventions for cognition in this high-risk population.