Total testosterone and neuropsychiatric symptoms in elderly men with Alzheimer's disease.
BACKGROUND
There has been a significant increase in the use of testosterone in aging men, but little investigation into its impact on men with Alzheimer's disease (AD). The findings of the few studies that have been done are inconsistent. In the present study, we investigated the relationship between total testosterone (TT) and neuropsychiatric symptoms (NPS) in a well-characterized sample of elderly men with mild to moderate AD.


METHODS
The sample, which was drawn from the Texas Alzheimer's Research Care Consortium Longitudinal Research Cohort, included 87 men who met the criteria for mild to moderate AD. The occurrence of NPS was gathered from caregivers and/or family members with the Neuropsychiatric Inventory. TT was analyzed, and the sample was divided into a low-testosterone group (TT ≤2.5 ng/ml; n = 44) and a borderline/normal group (TT ≥2.6 ng/ml; n = 43).


RESULTS
TT was correlated with symptoms of hallucinations, delusions, agitation, irritability and motor activity. The borderline/normal group was significantly more likely to have hallucinations (odds ratio (OR) = 5.56), delusions (OR = 3.87), motor activity (OR = 3.13) and irritability (OR = 2.77) than the low-testosterone group. Health status and apolipoprotein E ε4 status were not significant factors.


CONCLUSIONS
The findings of the present study have implications for the use of testosterone replacement therapy in men with AD or the prodromal stage of the disease.
Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA ; Department of Psychiatry and Behavioral Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
James R
JR
Hall
Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA ; Department of Psychiatry and Behavioral Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
April R
AR
Wiechmann
Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA ; Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
Rebecca L
RL
Cunningham
Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA ; Department of Internal Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
Leigh A
LA
Johnson
Department of Internal Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
Melissa
M
Edwards
Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA ; Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
Robert C
RC
Barber
Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA ; Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
Meharvan
M
Singh
Department of Psychiatry and Behavioral Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
Scott
S
Winter
Institute of Aging and Alzheimer's Disease Research, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA ; Department of Internal Medicine, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, Texas 76107 USA.
Sid E
SE
O'Bryant