title: Bioavailable testosterone is associated with a reduced risk of amnestic mild cognitive impairment in older men.
abstract: OBJECTIVE
  We investigated the risk of amnestic mild cognitive impairment (aMCI) in relation to serum bioavailable (BT) and total testosterone (TT) levels in older men.
  
  
  METHODS
  A cross-sectional study in an ambulatory setting, with older men aged 55-93 years with normal cognition, aMCI and Alzheimer's disease (AD).
  
  
  METHODS
  Morning serum BT and TT levels were determined. AD was diagnosed by the Neurological and Communicative Disorders and Stroke/Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) criteria for probable AD and aMCI by the Petersen criteria.
  
  
  RESULTS
  We recruited 203 Chinese older men (48 aMCI, 66 AD and 89 with normal cognition). Mean serum BT, but not TT, levels were significantly lower in the aMCI (mean BT +/- SEM 1.06 +/- 0.10 nmol/l) and AD (0.99 +/- 0.08 nmol/l) groups than in the normal controls (1.82 +/- 0.12 nmol/l) (P < 0.001, one-way anova) with no significant difference between the aMCI and AD groups. After adjustment for education, age and apolipoprotein E (apoE) genotype, logistic regression analyses showed that the serum BT level [adjusted odds ratio (OR) = 0.52, 95% confidence interval (CI) 0.32-0.85] was an independent protective factor for aMCI. For the combined outcome of aMCI and AD, the serum BT level was an independent protective factor but age and apoE epsilon4 were independent risk factors. There was no interaction between BT and age.
  
  
  CONCLUSIONS
  In older men, serum BT, but not TT, levels were associated with a lower risk of aMCI and AD.
authors.affiliation: Division of Geriatric Medicine, Department of Medicine, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong SAR. lwchu@hkucc.hku.hk
authors.forename: Leung-Wing
authors.initials: LW
authors.lastname: Chu
authors.forename: Sidney
authors.initials: S
authors.lastname: Tam
authors.forename: Peter W H
authors.initials: PW
authors.lastname: Lee
authors.forename: Rachel L C
authors.initials: RL
authors.lastname: Wong
authors.forename: Ping-Yiu
authors.initials: PY
authors.lastname: Yik
authors.forename: Wilson
authors.initials: W
authors.lastname: Tsui
authors.forename: Youqiang
authors.initials: Y
authors.lastname: Song
authors.forename: Bernard M Y
authors.initials: BM
authors.lastname: Cheung
authors.forename: John E
authors.initials: JE
authors.lastname: Morley
authors.forename: Karen S L
authors.initials: KS
authors.lastname: Lam
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000097:blood*; D001682:Biological Availability; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000097:blood*; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013739:Testosterone / Q000097:blood*
chemical_list: D013739:Testosterone