The Effects of Testosterone Supplementation on Cognitive Functioning in Older Men.
The Effects of Testosterone Supplementation on Cognitive Functioning in Older Men.
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DOI：
10.2174/1871527315666151110125704
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发表时间：
2016
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影响因子：
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通讯作者：
Martins RN
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文献类型：
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作者：
Wahjoepramono EJ;Asih PR;Aniwiyanti V;Taddei K;Dhaliwal SS;Fuller SJ;Foster J;Carruthers M;Verdile G;Sohrabi HR;Martins RN
男性在衰老过程中睾酮水平的降低与认知能力下降和痴呆症的风险有关。动物研究表明，睾酮补充剂在改善认知和减少阿尔茨海默病病理方面有好处。在一项随机、安慰剂对照、交叉研究中，我们调查了睾酮治疗是否显著改善了认知功能各种指标的表现。在随机分为两组之前，对44名男性进行了一系列神经心理学测试，以建立基线。第一组（A组）接受24周的睾酮治疗（T治疗），随后进行4周的洗脱，然后接受24周的安慰剂（P）;第二组（B组）接受相同的治疗，顺序相反（安慰剂，洗脱，然后T治疗）。在A组（TèP）中，与基线相比，睾酮治疗后通过简易精神状态检查（MMSE）测量的一般认知功能有适度（1分）但显著的改善。这种较基线的改善在洗脱期和交叉至安慰剂治疗后持续。当比较睾酮治疗与安慰剂时，观察到类似的简易精神状态检查（MMSE）评分。在B组（PèT）中，观察到睾酮治疗后较基线显著增加，与安慰剂治疗相比有增加的趋势。在两组中，在睾酮/安慰剂治疗后观察到基线抑郁评分（通过老年抑郁量表评估）的改善，并且在比较睾酮与安慰剂治疗时没有观察到差异。我们的研究结果表明，睾酮治疗对整体认知有一定的改善。现在需要更大规模的临床试验，更长时间的随访，并纳入血液和脑成像标记物，以最终确定睾酮治疗的意义。
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 (TèP), 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 (PèT) 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.