The Effects of Testosterone on Cognitive Functioning in Older Men.

Nelson Vergel

Founder, ExcelMale.com
Wahjoepramono EJ, Asih PR, Aniwiyanti V, et al.

The Effects of Testosterone Supplementation on Cognitive Functioning in Older Men. CNS Neurol Disord Drug Targets.

http://www.eurekaselect.com/136786/article

Reduction in testosterone levels in men during aging is associated with cognitive decline and risk of dementia. Animal studies have shown benefits for testosterone supplementation in improving cognition and reducing Alzheimer's disease pathology.

In a randomized, placebo-controlled, crossover study of men with subjective memory complaint and low testosterone levels, we investigated whether testosterone treatment significantly improved performance on various measures of cognitive functioning. Forty-four men were administered a battery of neuropsychological tests to establish the baseline prior to being randomly divided into two groups.

The first group (Group A) received 24 weeks of testosterone treatment (T treatment) followed by 4 weeks washout, and then 24 weeks of placebo (P);
The second group (Group B) received the same treatments, in reverse order (Placebo, washout, and then T treatment).

In group A (TP), compared to baseline, there was a modest (1 point) but significant improvement in general cognitive functioning as measured by the Mini Mental State Examination (MMSE) following testosterone treatment. This improvement from baseline was sustained following the washout period and crossover to placebo treatment. Similar Mini Mental State Examination (MMSE) scores were observed when comparing testosterone treatment with placebo.

In group B (PT), a significant increase was observed from baseline following testosterone treatment and a trend towards an increase when compared to placebo treatment.

Improvements in baseline depression scores (assessed by Geriatric Depression Scale) were observed following testosterone/placebo treatment in both groups, and no difference was observed when comparing testosterone with placebo treatment.

Our findings indicate a modest improvement on global cognition with testosterone treatment. Larger clinical trials with a longer follow- up and with the inclusion of blood and brain imaging markers are now needed to conclusively determine the significance of testosterone treatment.
 
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I continue to be amazed at the bias against TRT in the elderly. I

discussed it with my 86 year old fathers endocrinologist. I mentioned I was concerned about sarcopenia ultimately effecting his abilty to perform daily tasks and aksed if TRT could help that as well as make him feel better. She replied that "we don't want to increase the risk of prostate cancer". I told her that since he is 86 if he dies of cancer 10 years from now but feels better in the interim my father would probably find that to be a good result!

Her reply (and I am not making this up) is that "we don't give people medicine just to make them feel better"

I guess if you are over 80 you have no right to expect to feel well......
 
waltkowalski

That is sad but very common. Some doctors fear liability also. They gladly give old men finasteride which blocks DHT but never TRT. Heck, they do not even want to prescribe testosterone to men who are wasting or frail.
 

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Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

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Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

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The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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