The andropause and memory loss: is there a link between androgen decline and dementia in the aging male?
Studies demonstrate a decline in androgens with age and this results in the andropause. The objective of this paper is to review the literature on hormonal changes that occur in the aging males and determine if there are associations between decreased testosterone, dehydroepiandrosterone (DHEA) and decreased cognitive function. Trials of androgen replacement and its impact on cognitive function will also be analyzed. Method of analysis will be by a thorough search of articles on MEDLINE, the Internet and major abstract databases. Results of the author's own research in 302 men of the association of memory loss as a symptom in the andropause will be presented. In addition, the authors open trial of testosterone replacement in hypogonadic men with Alzheimer's disease will also be presented. The results of the author's trial will be compared with other investigators. High endogenous testosterone level predicted better performance on visual spatial tests in several studies, but not in all studies. Likewise, testosterone replacement in hypogonadic patients improved cognitive functions in some but not all studies. Testosterone has also been shown to improve cognitive function in eugonadal men. Several studies have shown that declines in DHEA may contribute to Alzheimer's disease and the results of double blind studies with DHEA replacement and its effect on cognition will also be presented. In summary, there is still no consensus that androgen replacement is beneficial in cognitive decline but this option may prove promising in some patients.
Tan
R S
RS
Geriatric Medicine Fellowship Program, University of Texas, Houston, United States. robert.s.tan@uth.tmc.edu
Pu
S J
SJ
D000375:Aging / Q000378:metabolism*; D000728:Androgens / Q000378:metabolism*; D002979:Climacteric / Q000502:physiology*; D003704:Dementia / Q000378:metabolism*; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000378:metabolism*
D000728:Androgens