Effects of Testosterone Therapy on Cognitive Function in Aging: A Systematic Review

Hua, Jeremy; Hildreth, Kerry L.; Pelak, Victoria S.

doi:10.1097/wnn.0000000000000104

Cited by 50 publications

(40 citation statements)

References 98 publications

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“…The limited previous studies in this area have suggested an advantage for androgenic progestins in the area of mental rotation [36,37]. Our findings expand this to include visuospatial learning and recall, which is also a cognitive domain where better performance has been linked to endogenous [53] and exogenous testosterone [54,55] in females. Furthermore, visuospatial learning has been linked to hippocampal androgen receptor activation in animal models [56].…”

Section: Discussionsupporting

confidence: 67%

Effects of Oral Contraceptive Androgenicity on Visuospatial and Social-Emotional Cognition: A Prospective Observational Trial

et al. 2020

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Oral contraceptives (OCs) containing estrogen and progesterone analogues are widely used amongst reproductive-aged women, but their neurocognitive impact is poorly understood. Preliminary studies suggest that OCs improve verbal memory and that OCs with greater androgenic activity may improve visuospatial ability. We sought to explore the cognitive impact of OCs by assessing performance of OC users at different stages of the OC cycle, and comparing this performance between users of different OC formulations according to known androgenic activity. We conducted a prospective, observational trial of OC users, evaluating cognitive performance with CogState software on two occasions: days 7–10 of active hormonal pill phase, and days 3–5 of the inactive pill phase (coinciding with the withdrawal bleed resembling menstruation). Thirty-five OC users (18 taking androgenic formulations, 17 taking anti-androgenic) were assessed. Analysis by androgenic activity showed superior performance by users of androgenic OCs, as compared to anti-androgenic OCs, in visuospatial ability and facial affect discrimination tasks. A growing understanding of cognitive effects of OC progestin androgenicity may have implications in choice of OC formulation for individuals and in future OC development.

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Section: Discussionsupporting

confidence: 67%

Effects of Oral Contraceptive Androgenicity on Visuospatial and Social-Emotional Cognition: A Prospective Observational Trial

et al. 2020

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“…Earlier studies have addressed cross‐sectional associations of indices of cognition with sex steroid status. These studies, which we do not discuss in detail, have been reviewed elsewhere 2,3 . Although there have also been negative or even opposite findings, several of these studies reported cross‐sectional associations of higher (or optimal) T levels, and more in particular free or bioavailable T levels, with either better global cognition according to the MMSE or better performance in particular areas of cognition.…”

Section: Cognitionmentioning

confidence: 99%

Role of testosterone in cognition and mobility of aging men

Kaufman

Lapauw

2020

Andrology

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Background Cognitive decline and impairment of physical performance and mobility are age‐related clinical problems with major negative impact on quality of life of elderly men. In how far the decline of testosterone production contributes to these problems in older men and whether testosterone therapy can contribute to slow down, prevent, or reverse their development remains subjects of debate. Objectives This narrative review presents the current knowledge on association of sex steroid status with cognitive decline and impairment of physical function and mobility in elderly men and on the effects of testosterone therapy on cognition and on physical performance and mobility in elderly men. Materials and Method The review is based on electronic database searches with primary focus on evidence from larger prospective observational studies and from controlled randomized trials, respectively. Results In most observational studies, testosterone levels do not predict cognitive decline or development of Alzheimer's disease. In randomized trials, testosterone therapy did not significantly affect cognition in men with low or low‐to‐normal serum testosterone, regardless of whether they have preexisting cognitive impairment. Overall, observational data indicate that the usually moderate decline of androgen exposure in older men cannot fully account for the parallel decline of physical performance and mobility. Trials of testosterone therapy in older men with low or low‐normal serum testosterone, whether they were generally healthy or suffered from physical function impairments, either did not show any effect on mobility and physical performance or showed limited effects of uncertain clinical relevancy. Discussion and Conclusions The whole of the evidence tends to downplay the role of sex steroid status in the decline of cognitive function and impairment of physical function and mobility in older men. Based on the available evidence, prevention or treatment of cognitive decline or of impairment of mobility and physical function are not valid indications for testosterone treatment in older men with low or low‐to‐normal serum testosterone levels.

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“…Low serum free testosterone correlates with depressive symptoms in the elderly and seems to be associated with a decline in neuropsychologic function, although causeeffect cannot be definitively assessed, since no clear benefit to revert this situation with testosterone replacement therapy has been demonstrated (Hua et al 2016).…”

Section: Neuropsychiatric Functionsmentioning

confidence: 99%

Impact of Endocrine Disorders in the Elderly

Sunsundegui¹,

Santesteban-Moriones²,

Landecho³

2019

Endocrinology

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Aging is a complex and heterogeneous process that results from the accumulation of a wide variety of damage over time that leads to a progressive loss of physiological abilities named, in sum, elderly. Deterioration of function is generally detectable first as a loss of physiological reserve expressed as the incapacity to restore homeostasis under stress and later by altered function at rest. It entails sequentially frailty, disease and ultimately death. In considering the impact of endocrine disorders in the elderly, it is essential to distinguish between the effects of aging per se on endocrine physiology and those caused by age-related illness. The only endocrine system for which there is a universal change in function with age is the hypothalamic-pituitary-gonadal axis in women. Age impacts in a very variable manner the body composition and the circadian pattern of body temperature, plasma cortisol, and sleep and can cause desynchronization or "internal phase drift." This chapter summarizes the major changes in the endocrine organ function related to the aging process, and also some habits that have proven to delay the physiological-functions derangement, as healthy diet and exercise.

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Effects of Testosterone Therapy on Cognitive Function in Aging: A Systematic Review

Cited by 50 publications

References 98 publications

Effects of Oral Contraceptive Androgenicity on Visuospatial and Social-Emotional Cognition: A Prospective Observational Trial

Effects of Oral Contraceptive Androgenicity on Visuospatial and Social-Emotional Cognition: A Prospective Observational Trial

Role of testosterone in cognition and mobility of aging men

Impact of Endocrine Disorders in the Elderly

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