scholarly journals Testosterone Treatment and Cognitive Function in Older Men With Low Testosterone and Age-Associated Memory Impairment

JAMA ◽  
2017 ◽  
Vol 317 (7) ◽  
pp. 717 ◽  
Author(s):  
Susan M. Resnick ◽  
Alvin M. Matsumoto ◽  
Alisa J. Stephens-Shields ◽  
Susan S. Ellenberg ◽  
Thomas M. Gill ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Memory Impairment ◽  
Older Men ◽  
Testosterone Treatment ◽  
Low Testosterone

scholarly journals The Effect of Testosterone on Cardiovascular Biomarkers in the Testosterone Trials

2017 ◽  
Vol 103 (2) ◽  
pp. 681-688 ◽  
Author(s):  
Emile R Mohler ◽  
Susan S Ellenberg ◽  
Cora E Lewis ◽  
Nanette K Wenger ◽  
Matthew J Budoff ◽  
...  
Keyword(s):  
Cardiovascular Risk ◽  
Density Lipoprotein ◽  
Older Men ◽  
The United States ◽  
Mean Difference ◽  
Lipoprotein Cholesterol ◽  
Model Assessment ◽  
Testosterone Treatment ◽  
Low Testosterone ◽  
Cardiovascular Biomarkers

Abstract Context Studies of the possible cardiovascular risk of testosterone treatment are inconclusive. Objective To determine the effect of testosterone treatment on cardiovascular biomarkers in older men with low testosterone. Design Double-blind, placebo-controlled trial. Setting Twelve academic medical centers in the United States. Participants In all, 788 men ≥65 years old with an average of two serum testosterone levels <275 ng/dL who were enrolled in The Testosterone Trials. Intervention Testosterone gel, the dose adjusted to maintain the testosterone level in the normal range for young men, or placebo gel for 12 months. Main Outcome Measures Serum markers of cardiovascular risk, including lipids and markers of glucose metabolism, fibrinolysis, inflammation, and myocardial damage. Results Compared with placebo, testosterone treatment significantly decreased total cholesterol (adjusted mean difference, −6.1 mg/dL; P < 0.001), high-density lipoprotein cholesterol (adjusted mean difference, −2.0 mg/dL; P < 0.001), and low-density lipoprotein cholesterol (adjusted mean difference, −2.3 mg/dL; P = 0.051) from baseline to month 12. Testosterone also slightly but significantly decreased fasting insulin (adjusted mean difference, −1.7 µIU/mL; P = 0.02) and homeostatic model assessment‒insulin resistance (adjusted mean difference, −0.6; P = 0.03). Testosterone did not change triglycerides, d-dimer, C-reactive protein, interleukin 6, troponin, glucose, or hemoglobin A1c levels more than placebo. Conclusions and Relevance Testosterone treatment of 1 year in older men with low testosterone was associated with small reductions in cholesterol and insulin but not with other glucose markers, markers of inflammation or fibrinolysis, or troponin. The clinical importance of these findings is unclear and requires a larger trial of clinical outcomes.

scholarly journals Testosterone and cognitive function: current clinical evidence of a relationship

2006 ◽  
Vol 155 (6) ◽  
pp. 773-781 ◽  
Author(s):  
Olivier Beauchet
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Cognitive Ability ◽  
Cognitive Dysfunction ◽  
Clinical Evidence ◽  
Serum Testosterone ◽  
Older Men ◽  
Testosterone Levels ◽  
Testosterone Substitution ◽  
Low Testosterone

Background: Testosterone levels decline as men age, as does cognitive function. Whether there is more than a temporal relationship between testosterone and cognitive function is unclear. Chemical castration studies in men with prostate cancer suggest that low serum testosterone may be associated with cognitive dysfunction. Low testosterone levels have also been observed in patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI). This paper reviews the current clinical evidence of the relationship between serum testosterone levels and cognitive function in older men. Methods: A systematic literature search was conducted using PubMed and EMBASE to identify clinical studies and relevant reviews that evaluated cognitive function and endogenous testosterone levels or the effects of testosterone substitution in older men. Results: Low levels of endogenous testosterone in healthy older men may be associated with poor performance on at least some cognitive tests. The results of randomized, placebo-controlled studies have been mixed, but generally indicate that testosterone substitution may have moderate positive effects on selective cognitive domains (e.g. spatial ability) in older men with and without hypogonadism. Similar results have been found in studies in patients with existing AD or MCI. Conclusions: Low endogenous levels of testosterone may be related to reduced cognitive ability, and testosterone substitution may improve some aspects of cognitive ability. Measurement of serum testosterone should be considered in older men with cognitive dysfunction. For men with both cognitive impairment and low testosterone, testosterone substitution may be considered. Large, long-term studies evaluating the effects of testosterone substitution on cognitive function in older men are warranted.

scholarly journals Effect of Testosterone Treatment on Volumetric Bone Density and Strength in Older Men With Low Testosterone

2017 ◽  
Vol 177 (4) ◽  
pp. 471 ◽  
Author(s):  
Peter J. Snyder ◽  
David L. Kopperdahl ◽  
Alisa J. Stephens-Shields ◽  
Susan S. Ellenberg ◽  
Jane A. Cauley ◽  
...  
Keyword(s):  
Bone Density ◽  
Older Men ◽  
Testosterone Treatment ◽  
Low Testosterone ◽  
Volumetric Bone Density

scholarly journals Testosterone Treatment and Coronary Artery Plaque Volume in Older Men With Low Testosterone

JAMA ◽  
2017 ◽  
Vol 317 (7) ◽  
pp. 708 ◽  
Author(s):  
Matthew J. Budoff ◽  
Susan S. Ellenberg ◽  
Cora E. Lewis ◽  
Emile R. Mohler ◽  
Nanette K. Wenger ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Older Men ◽  
Plaque Volume ◽  
Coronary Artery Plaque ◽  
Testosterone Treatment ◽  
Low Testosterone

Benefits and Risks of Testosterone Treatment in Men with Age-Related Decline in Testosterone

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Marcelo Rodrigues dos Santos ◽  
Shalender Bhasin
Keyword(s):  
Prostate Cancer Risk ◽  
Older Men ◽  
Annual Review ◽  
Publication Date ◽  
Long Term Effects ◽  
Endocrine Society ◽  
Testosterone Treatment ◽  
Testosterone Levels ◽  
Age Related ◽  
Low Testosterone

The substantial increase in life expectancy of men has focused growing attention on quality-of-life issues associated with reproductive aging. Serum total and free testosterone levels in men, after reaching a peak in the second and third decade of life, decline gradually with advancing age. The trajectory of age-related decline is affected by comorbid conditions, adiposity, medications, and genetic factors. Testosterone treatment of older men with low testosterone levels improves overall sexual activity, sexual desire, and erectile function; improves areal and volumetric bone density, as well as estimated bone strength in the spine and the hip; corrects unexplained anemia of aging; increases skeletal muscle mass, strength and power, self-reported mobility, and some measures of physical function; and modestly improves depressive symptoms. The long-term effects of testosterone on major cardiovascular events and prostate cancer risk remain unclear. The Endocrine Society recommends against testosterone therapy of all older men with low testosterone levels but suggests consideration of treatment on an individualized basis in men who have consistently low testosterone levels and symptoms or conditions suggestive of testosterone deficiency. Expected final online publication date for the Annual Review of Medicine, Volume 72 is January 27, 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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