Effects of Transdermal Testosterone on Cognitive Function and Health Perception in Older Men With Low Bioavailable Testosterone Levels

Abstract The objective of this study was to determine whether endogenous sex hormone levels predict cognitive function in older men. Our study design was an exploratory analysis in a population-based cohort in Rancho Bernardo, California. The study participants were 547 community-dwelling men 59–89 yr of age at baseline who were not using testosterone or estrogen therapy. Between 1984 and 1987, sera were collected for measurement of endogenous total and bioavailable testosterone and estradiol levels. Between 1988 and 1991, 12 standard neuropsychological instruments were administered, including two items from the Blessed Information-Memory-Concentration (BIMC) Test, three measures of retrieval from the Buschke-Fuld Selective Reminding Test, a category fluency test, immediate and delayed recall from the Visual Reproduction Test, the Mini-Mental State Examination with individual analysis of the Serial Sevens and the “World” Backwards components, and the Trail-Making Test Part B. In age- and education-adjusted analyses, men with higher levels of total and bioavailable estradiol had poorer scores on the BIMC Test and Mini-Mental State Examination. Men with higher levels of bioavailable testosterone had better scores on the BIMC Test and the Selective Reminding Test (long-term storage). Five associations were U-shaped: total testosterone and total and bioavailable estradiol with the BIMC Test; bioavailable testosterone with the “World” test; and total estradiol with the Trail-Making Test. All associations were relatively weak but independent of age, education, body mass index, alcohol use, cigarette smoking and depression. In these older men, low estradiol and high testosterone levels predicted better performance on several tests of cognitive function. Linear and nonlinear associations were also found, suggesting that an optimal level of sex hormones may exist for some cognitive functions.

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Effects of Transdermal Testosterone on Bone and Muscle in Older Men with Low Bioavailable Testosterone Levels, Low Bone Mass, and Physical Frailty

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2010.02865.x ◽

2010 ◽

Vol 58 (6) ◽

pp. 1134-1143 ◽

Cited By ~ 146

Author(s):

Anne M. Kenny ◽

Alison Kleppinger ◽

Kristen Annis ◽

Margaret Rathier ◽

Bruce Browner ◽

...

Keyword(s):

Bone Mass ◽

Older Men ◽

Low Bone Mass ◽

Physical Frailty ◽

Testosterone Levels ◽

Bioavailable Testosterone

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Testosterone and cognitive function: current clinical evidence of a relationship

Acta Endocrinologica ◽

10.1530/eje.1.02306 ◽

2006 ◽

Vol 155 (6) ◽

pp. 773-781 ◽

Cited By ~ 87

Author(s):

Olivier Beauchet

Keyword(s):

Cognitive Impairment ◽

Cognitive Function ◽

Cognitive Ability ◽

Cognitive Dysfunction ◽

Clinical Evidence ◽

Serum Testosterone ◽

Older Men ◽

Testosterone Levels ◽

Testosterone Substitution ◽

Low Testosterone

Background: Testosterone levels decline as men age, as does cognitive function. Whether there is more than a temporal relationship between testosterone and cognitive function is unclear. Chemical castration studies in men with prostate cancer suggest that low serum testosterone may be associated with cognitive dysfunction. Low testosterone levels have also been observed in patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). This paper reviews the current clinical evidence of the relationship between serum testosterone levels and cognitive function in older men. Methods: A systematic literature search was conducted using PubMed and EMBASE to identify clinical studies and relevant reviews that evaluated cognitive function and endogenous testosterone levels or the effects of testosterone substitution in older men. Results: Low levels of endogenous testosterone in healthy older men may be associated with poor performance on at least some cognitive tests. The results of randomized, placebo-controlled studies have been mixed, but generally indicate that testosterone substitution may have moderate positive effects on selective cognitive domains (e.g. spatial ability) in older men with and without hypogonadism. Similar results have been found in studies in patients with existing AD or MCI. Conclusions: Low endogenous levels of testosterone may be related to reduced cognitive ability, and testosterone substitution may improve some aspects of cognitive ability. Measurement of serum testosterone should be considered in older men with cognitive dysfunction. For men with both cognitive impairment and low testosterone, testosterone substitution may be considered. Large, long-term studies evaluating the effects of testosterone substitution on cognitive function in older men are warranted.

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