Testosterone Treatment and Cognitive Function in Older Men With Low Testosterone and Age-Associated Memory Impairment
- PMID: 28241356
- PMCID: PMC5433758
- DOI: 10.1001/jama.2016.21044
Testosterone Treatment and Cognitive Function in Older Men With Low Testosterone and Age-Associated Memory Impairment
Abstract
Importance: Most cognitive functions decline with age. Prior studies suggest that testosterone treatment may improve these functions.
Objective: To determine if testosterone treatment compared with placebo is associated with improved verbal memory and other cognitive functions in older men with low testosterone and age-associated memory impairment (AAMI).
Design, setting, and participants: The Testosterone Trials (TTrials) were 7 trials to assess the efficacy of testosterone treatment in older men with low testosterone levels. The Cognitive Function Trial evaluated cognitive function in all TTrials participants. In 12 US academic medical centers, 788 men who were 65 years or older with a serum testosterone level less than 275 ng/mL and impaired sexual function, physical function, or vitality were allocated to testosterone treatment (n = 394) or placebo (n = 394). A subgroup of 493 men met criteria for AAMI based on baseline subjective memory complaints and objective memory performance. Enrollment in the TTrials began June 24, 2010; the final participant completed treatment and assessment in June 2014.
Interventions: Testosterone gel (adjusted to maintain the testosterone level within the normal range for young men) or placebo gel for 1 year.
Main outcomes and measures: The primary outcome was the mean change from baseline to 6 months and 12 months for delayed paragraph recall (score range, 0 to 50) among men with AAMI. Secondary outcomes were mean changes in visual memory (Benton Visual Retention Test; score range, 0 to -26), executive function (Trail-Making Test B minus A; range, -290 to 290), and spatial ability (Card Rotation Test; score range, -80 to 80) among men with AAMI. Tests were administered at baseline, 6 months, and 12 months.
Results: Among the 493 men with AAMI (mean age, 72.3 years [SD, 5.8]; mean baseline testosterone, 234 ng/dL [SD, 65.1]), 247 were assigned to receive testosterone and 246 to receive placebo. Of these groups, 247 men in the testosterone group and 245 men in the placebo completed the memory study. There was no significant mean change from baseline to 6 and 12 months in delayed paragraph recall score among men with AAMI in the testosterone and placebo groups (adjusted estimated difference, -0.07 [95% CI, -0.92 to 0.79]; P = .88). Mean scores for delayed paragraph recall were 14.0 at baseline, 16.0 at 6 months, and 16.2 at 12 months in the testosterone group and 14.4 at baseline, 16.0 at 6 months, and 16.5 at 12 months in the placebo group. Testosterone was also not associated with significant differences in visual memory (-0.28 [95% CI, -0.76 to 0.19]; P = .24), executive function (-5.51 [95% CI, -12.91 to 1.88]; P = .14), or spatial ability (-0.12 [95% CI, -1.89 to 1.65]; P = .89).
Conclusions and relevance: Among older men with low testosterone and age-associated memory impairment, treatment with testosterone for 1 year compared with placebo was not associated with improved memory or other cognitive functions.
Trial registration: clinicaltrials.gov Identifier: NCT00799617.
Conflict of interest statement
Figures
![Figure 1](https://cdn.statically.io/img/www.ncbi.nlm.nih.gov/pmc/articles/instance/5433758/bin/nihms857019f1.gif)
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Comment in
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Testosterone and Male Aging: Faltering Hope for Rejuvenation.JAMA. 2017 Feb 21;317(7):699-701. doi: 10.1001/jama.2017.0129. JAMA. 2017. PMID: 28241336 No abstract available.
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Gegen das Altern hilft auch kein Testosteron.MMW Fortschr Med. 2017 May;159(8):42. doi: 10.1007/s15006-017-9573-x. MMW Fortschr Med. 2017. PMID: 28466321 German. No abstract available.
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In older men with low testosterone levels and age-associated memory impairment, testosterone did not improve memory.Ann Intern Med. 2017 May 16;166(10):JC56. doi: 10.7326/ACPJC-2017-166-10-056. Ann Intern Med. 2017. PMID: 28505640 No abstract available.
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Testosterone treatment in older men: glass half empty or half full?Asian J Androl. 2017 Sep-Oct;19(5):512-514. doi: 10.4103/aja.aja_14_17. Asian J Androl. 2017. PMID: 28566558 Free PMC article.
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Cognitive Function After Testosterone Treatment.JAMA. 2017 Jun 13;317(22):2335. doi: 10.1001/jama.2017.5241. JAMA. 2017. PMID: 28609527 No abstract available.
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