Testosterone Loss and Estradiol Administration Modify Memory in Men

Beer, Tomasz M.; Bland, Lisa B.; Bussiere, Joseph R.; Neiss, Michelle B.; Wersinger, Emily M.; Garzotto, Mark; Ryan, Christopher W.; Janowsky, Jeri S.

doi:10.1016/s0022-5347(05)00049-2

Cited by 110 publications

(64 citation statements)

References 20 publications

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“…15 Androgen blockade in prostate cancer patients leads to a rise in depression and anxiety symptoms and weakening of verbal memory. 16,17 In contrast, testosterone supplementation leads to an improvement in the sense of well being and a rise in libido. 18 Because of the effects of mood and libido on sexual performance, we determined the rate of hypogonadism in an ED referral population.…”

Section: Discussionmentioning

confidence: 99%

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

et al. 2007

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Depression and hypogonadism are associated with erectile dysfunction (ED). We evaluated the prevalence of both conditions in men presenting to an ED specialty clinic, and tested whether hypogonadism correlated with the presence of depressive symptoms using a validated questionnaire. From July 2001 to June 2003, 157 men referred to an ED specialty clinic prospectively filled the Center for Epidemiologic Studies Depression Scale (CES-D), the abbreviated International Index of Erectile Function (IIEF-5) and had testosterone serum levels drawn. Median age was 53 (range ¼ 21-85 years). Hypogonadism, defined as serum T (testosterone)o300 mg/dl, was present in 36% of patients. This proportion was higher in men over the median age compared to younger patients (45 and 26%, respectively, P ¼ 0.002). Overt depression symptoms, defined as a CES-DX22, were found in 24% of men. Mean age of men with overt depression was 49.9710.1 years vs 55.1715.8 years for those with CES-Do22 (P ¼ 0.02). Hypogonadal men were more likely to have overt depression scores compared to eugonadal counterparts (35 vs 18%, P ¼ 0.02). This association was statistically stronger after correcting for age in a multivariate linear model (P ¼ 0.005). The relative risk of having overt depression was 1.94 times higher in men with hypogonadal testosterone level (95% confidence interval: 1.13 to 3.7). We conclude that in an ED referral population, symptoms of hypogonadism and depression symptoms are fairly prevalent, and that overt depression symptoms are strongly associated with hypogonadism. Clinicians should consider testosterone measurements in all men with high depression symptom scores.

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Section: Discussionmentioning

confidence: 99%

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

et al. 2007

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“…Based on the available evidence, it seems that the effects of ADT on cognition may indeed be minimal, but there is need for caution in drawing this conclusion about ADT and spatial memory, since that particular cognitive domain was not assessed in the Alibhai study, despite a sizeable scientific literature documenting its particular sensitivity to ADT. 32,36,37,51,52,54 There is mixed evidence of estrogen effects on cognition in men receiving ADT, with one study suggesting possible benefits to verbal memory 44 and another suggesting possible decrements. 53 Earlier studies have been critiqued for design weaknesses, including lack of estimation of practice effects, inconsistency of results, lack of effects across a number of domains, recruitment of well-educated samples that might not generalize to other samples, and use of methods that do not enable detection of subtle cognitive changes over time.…”

Section: Discussionmentioning

confidence: 99%

“…For that reason, we did not include studies that relied exclusively on experimental measures of cognitive performance 43 which are not validated clinically and have no norms. Similarly, we did not review studies that included only global measures of cognition such as the total score on the High Sensitivity Cognitive Screen, 44,45 because such measures were developed and validated to detect gross cognitive impairment as contrasted with more subtle cognitive difficulties within specific cognitive domains.…”

Section: Evidence For Cognitive Effects Of Testosteronementioning

confidence: 99%

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Cognitive changes associated with ADT: a review of the literature

Jamadar¹,

Winters²,

Maki³

2012

Asian J Androl

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The use of androgen deprivation therapy (ADT) has increased since the early 1990s after early detection efforts and greater use of the prostate-specific antigen (PSA) test. Although ADT is associated with favorable clinical outcomes, ADT has been associated with an increased risk for cardiovascular disease, increased serum cholesterol, triglycerides, insulin resistance, body mass index and fat body mass. Here we review findings from 11 clinical studies examining the effects of ADT on cognition as measured by standardized tests in cognitive domains such as verbal and spatial memory. Most of these studies have important limitations, including small sample sizes, suboptimal control groups and baseline group differences in confounding factors. Despite these limitations, the best designed studies, those comparing patients on ADT to healthy controls, generally suggest that spatial memory might be especially sensitive to the effects of ADT. Critically, to date there is only one study involving random assignment of ADT versus close clinical observation. That study revealed a decrease in verbal memory with ADT, but was limited in sample size and did not include a measure of spatial memory. A recent observational study revealed no substantial evidence of cognitive impairment with ADT, even in the domain of verbal memory. Like the randomized study, however, this large observational study lacked a measure of spatial memory. Overall, the studies with the best controls suggest a potential negative impact of ADT on spatial memory, and perhaps verbal memory, and a need for continued investigation of the impact of ADT on cognition, particularly in these two cognitive domains.

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“…Visuospatial function seems particularly related to androgen status [62]. Memory impairment encountered in medically androgen deprived men, disappears after treatment discontinuation [64][65][66][67]. A relationship between low T levels, mild cognitive impairment (MCI) [68] and AD incidence has also been suggested [20,68].…”

Section: Cognitive Disordersmentioning

confidence: 99%

A view of geriatrics through hormones. What is the relation between andropause and well-known geriatric syndromes?

Samaras

Lang

et al. 2013

Maturitas

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a b s t r a c tAge related male hypogonadism, or "andropause", is increasingly recognized as of frequent occurrence in older patients. Diagnosis requires both the presence of clinical symptoms and low testosterone levels. However, diagnosing andropause in this age group may be challenging since symptoms are frequently non specific and testosterone levels are influenced by a multitude of parameters such as lifestyle factors and chronic diseases. In this article we discuss the pathophysiology, definition and diagnostic difficulties of andropause in geriatric patients. Moreover, we review the relation between testosterone levels and frequent geriatric syndromes such as falls, osteoporosis, cognitive and mood disorders, anemia and cardiovascular disease. Finally, we examine the potential benefits and risks of testosterone replacement therapy in this age group.

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Testosterone Loss and Estradiol Administration Modify Memory in Men

Abstract: Sex steroid loss and replacement have effects on specific cognitive processes in older men. Furthermore, estrogen has the potential to reverse the neurotoxic effects on memory performance caused by androgen deprivation.

Cited by 110 publications

References 20 publications

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

Hypogonadism is associated with overt depression symptoms in men with erectile dysfunction

Cognitive changes associated with ADT: a review of the literature

A view of geriatrics through hormones. What is the relation between andropause and well-known geriatric syndromes?

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