Potential Therapeutic Role of Androgens in Cognitive Loss Associated with Hypogonadism

Abstract

Memory problems late in life are common and are often easy to recognize. Hypogonadism in older men is not as readily identified, but it is also frequently a part of aging. Androgens, such as testosterone, have important hormonal influences on the brain and may prevent and possibly treat cognitive loss, including age-associated memory loss, mild cognitive impairment (MCI), and perhaps even Alzheimer’s disease (AD).There is support from small, prospective clinical trials that suggest the role of testosterone in improving cognitive function in normal men as well as hypogonadal men with AD. This improvement in cognitive function is subtle and is often only measurable on specialized neuropsychological batteries such as those that measure the visual-spatial domain. Patients often report measurable memory improvement in both declarative and procedural domains after receiving testosterone replacement therapy.The rise of gonadotropins, follicle-stimulating hormones (FSHs), and luteinizing hormones (LHs), has been associated with AD.The clinical significance of therapeutic strategies directed to reduce these levels remains to be determined. Current evidence showing that dehydroepiandrosterone (DHEA) improves cognitive function is ambiguous.