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Decline in reproductive hormones linked to cognitive change in older men
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Cognitive decline in older men may be associated with decline in androgen status; however, further studies are needed to understand the relationship, according to recent study findings published in The Journal of Clinical Endocrinology & Metabolism.
“This study provides the first comprehensive examination of the longitudinal associations between serum reproductive hormone levels, cognitive function and dementia in older men,” the researchers wrote.
David J. Handelsman, MD, PhD, FRACP, of the ANZAC Research Institute in Australia, and colleagues evaluated men aged 70 years and older from the Concord Health and Ageing in Men Project (CHAMP) at baseline (2005-2007; n = 1,705), 2-years follow-up (2007-2009; n = 1,367) and 5-years follow-up (2010-2013; n = 958) to determine the relationship between changes in reproductive hormone levels and cognitive decline over time.
The reproductive hormones testosterone, dihydrotestosterone (DHT), estradiol, estrone, sex hormone-binding globulin (SHBG), luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were all measured for evaluation. The Mini Mental State Examination (MMSE) was used to measure cognitive function at all three time points.
A positive association was found between baseline reproductive hormones and longitudinal change in MMSE and the follow-up timepoints for DHT (beta = 0.292) whereas negative associations were found for FSH (beta = 0.008) and LH (beta = -0.019). These findings suggests that lower DHT or higher FSH and LH at baseline are associated with greater cognitive decline. However, following adjustment for potential confounders, the associations were no longer significant.
Clinically significant cognitive decline was more likely in participants with high LH (OR = 0.76; 95% CI, 0.64-0.91); after adjustment for potential confounders this association did not remain significant. Decline in MMSE over the time-points were positively association with testosterone (P = .01), DHT (P = .02), estrone (P = .004) and calculated free testosterone (P = .002) whereas a negative association was found for SHBG (P = .02). Following adjustment for confounders only testosterone (P = .03), DHT (P = .04), calculated free testosterone (P = .02) and estrone (P = .002) remained significant.
“Our findings raise the possibility that decline in androgen status may be the consequence rather than the cause of cognitive decline consistent with the absence of significant cognitive decline in life-long hypogonadism as well as randomized placebo-controlled trials that find little or no benefits of [testosterone] treatment on cognitive function in older men,” the researchers wrote. “However, this study is observational, it could not fully rule out the possibility that cognitive decline and reproductive hormone decline are both independent results of aging. Nevertheless, our study suggests that reduced cognitive function may be an important but under recognized contributor to the lowering of androgen status in older men.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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