LAUSR

Key Points Question Are 5α-reductase inhibitors (5-ARIs), used for benign prostatic hyperplasia and androgenic alopecia, associated with an increased risk for all-cause dementia, Alzheimer disease, vascular dementia, depression, and suicide? Findings This register-based prospective cohort study in Sweden comprising 2 236 876 men found that, while 5-ARIs were associated with increased risk for all-cause dementia, Alzheimer disease, and vascular dementia after the start of treatment, the association became statistically insignificant over 4 years of exposure. There was no association between 5-ARIs and suicide, but both finasteride and dutasteride were associated with an increased risk for depression. Meaning This study suggests that 5-ARIs might be associated with depression; in contrast, the decreasing trend in the magnitude of the associations between 5-ARIs and dementia seem to be due to increased detection of undiagnosed dementia, particularly at the early stage of 5-ARI treatment.