title: The hormonal pathway to cognitive impairment in older men.
abstract: In older men there is a multiple hormonal dysregulation with a relative prevalence of catabolic hormones such as thyroid hormones and cortisol and a decline in anabolic hormones such as dehydroepiandrosterone sulphate, testosterone and insulin like growth factor 1 levels. Many studies suggest that  this catabolic milieu is an important predictor of frailty and mortality in older persons. There is a close relationship between frailty and cognitive impairment with studies suggesting that development of frailty is consequence of cognitive impairment and others pointing out that physical frailty is a determinant of cognitive decline. Decline in cognitive function, typically memory, is a major symptom of dementia. The "preclinical phase" of  cognitive impairment occurs many years before  the onset of dementia. The identification of relevant modifiable factors, including the hormonal dysregulation, may lead to therapeutic strategies for preventing the cognitive dysfunction. There are several mechanisms by which anabolic hormones play a role in neuroprotection and neuromodulation. These hormones facilitate recovery after brain injury and attenuate the neuronal loss. In contrast, elevated thyroid hormones may increase oxidative stress and apoptosis, leading to neuronal damage or death. In this mini review we will address  the relationship between low levels of anabolic hormones, changes in thyroid hormones and cognitive function in older men. Then, giving the contradictory data of the literature and the multi-factorial  origin of dementia, we will introduce the hypothesis of multiple hormonal derangement as a better determinant of cognitive decline in older men.
authors.affiliation: Department of Internal Medicine and Biomedical Sciences, Section of Geriatrics, University of Parma, Parma, Italy. marcellomaggio2001@yahoo.it
authors.forename: M
authors.initials: M
authors.lastname: Maggio
authors.forename: E
authors.initials: E
authors.lastname: Dall'Aglio
authors.forename: F
authors.initials: F
authors.lastname: Lauretani
authors.forename: C
authors.initials: C
authors.lastname: Cattabiani
authors.forename: G
authors.initials: G
authors.lastname: Ceresini
authors.forename: P
authors.initials: P
authors.lastname: Caffarra
authors.forename: G
authors.initials: G
authors.lastname: Valenti
authors.forename: R
authors.initials: R
authors.lastname: Volpi
authors.forename: A
authors.initials: A
authors.lastname: Vignali
authors.forename: G
authors.initials: G
authors.lastname: Schiavi
authors.forename: G P
authors.initials: GP
authors.lastname: Ceda
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology*; D003071:Cognition / Q000502:physiology; D003072:Cognition Disorders / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control; D019314:Dehydroepiandrosterone Sulfate / Q000378:metabolism; D003704:Dementia / Q000209:etiology* / Q000378:metabolism / Q000517:prevention & control; D016330:Frail Elderly; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008568:Memory / Q000502:physiology*; D013739:Testosterone / Q000378:metabolism; D013963:Thyroid Hormones / Q000378:metabolism
chemical_list: D006728:Hormones; D013963:Thyroid Hormones; D013739:Testosterone; D019314:Dehydroepiandrosterone Sulfate; D007334:Insulin-Like Growth Factor I