Testosterone Therapy May Help Elderly Men
With Mild Alzheimer's Disease
Testosterone replacement therapy may help improve
the quality of life for elderly men with mild
cases of Alzheimer's disease, according to
a study posted online today that will appear in
the February 2006 print issue of Archives of Neurology,
one of the Archives journals. "There is a
compelling need for therapies that prevent, defer
the onset, slow the progression, or improve the
symptoms of Alzheimer disease (AD)," the authors
provide as background information in the article.
They note that hormonal therapies have been the
focus of research attention in recent years since
male aging is associated with a gradual progressive
decline in testosterone levels. "The gradual
decline in testosterone level is associated with
decreased muscle mass and strength, osteoporosis,
decreased libido, mood alterations, and changes
in cognition, conditions that may be reversed
with testosterone replacement.
" The authors add that the age-related decline
in testosterone is potentially relevant to AD
as previous studies have found significantly lower
concentrations of the hormone in middle-aged and
elderly men who developed AD. Po H. Lu, Psy.D.,
from the David Geffen School of Medicine, University
of California, Los Angeles, and colleagues conducted
a 24-week, randomized study to evaluate the effects
of testosterone therapy on cognition, neuropsychiatric
symptoms, and quality of life in 16 male patients
with mild AD and 22 healthy elderly men who served
as controls. The study participants were randomized
to receive packets of gel to apply on their skin
that either contained testosterone or a placebo.
Standardized tests were administered at least
twice (baseline and end) during the study for
the assessment of cognitive functions and quality
of life. "For the patients with AD, the testosterone-treated
group had significantly greater improvements in
the scores on the caregiver version of the quality-of-life
scale," the researchers report.
"No significant treatment group differences
were detected in the cognitive scores at end of
study, although numerically greater improvement
or less decline on measures of visuospatial functions
was demonstrated with testosterone treatment compared
with placebo. In the healthy control group, a
nonsignificant trend toward greater improvement
in self-rated quality of life was observed in
the testosterone-treated group compared with placebo
treatment.
No difference between the treatment
groups was detected in the remaining outcome measures."
"In conclusion, the present results should
be considered preliminary and do not warrant routine
treatment of AD and healthy control men with testosterone.
Future studies with larger sample sizes are needed
before clinical decisions regarding testosterone
therapy can be rationally based.
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