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Role of androgens in mild cognitive impairment and possible interventions during andropause
R S Tan1, S J Pu, J W Culberson
1University of Texas Medical School, Houston 77030, USA. robert.s.tan@uth.tmc.edu
Abstract:
Mild cognitive impairment (MCI) is becoming fashionable as a diagnosis, representing a state of cognitive decline associated with negligible functional loss. MCI is important as it often precedes Alzheimer's disease (AD). Recognizing MCI may lead to preventive strategies that can delay the onset of AD. Many patients who transition into andropause report problems with their memory. There is strong evidence from basic sciences and epidemiological studies that both estrogens and androgens play a protective role in neurodegeneration. The evidence from small prospective clinical trials lends support to the role of hormones in improving cognitive function. The improvement in cognitive function with hormones is subtle and often not measurable on standard neuropsychological batteries. Patients have reported memory improvements in both declarative and procedural domains after being on hormonal replacement. Functional changes and vascular changes can be detected after hormonal replacement with more sophisticated imaging of the brain like positron emission tomography (PET) scans. We hypothesize androgens and perhaps selective androgen receptor modulators as future treatment options for MCI in aging males.
Insights
Mild cognitive impairment (MCI) in aging males may be linked to hormonal changes. Androgen replacement therapy shows potential for improving memory and cognitive function in men experiencing andropause.
Area of Science:
- Neuroscience
- Endocrinology
- Gerontology
Background:
- Mild cognitive impairment (MCI) is a precursor to Alzheimer's disease (AD).
- Hormonal changes during andropause are associated with memory complaints in aging males.
- Estrogens and androgens are known to play a neuroprotective role.
Purpose of the Study:
- To explore the role of androgens in cognitive function in aging males.
- To investigate the potential of hormonal replacement therapy for MCI.
- To identify future treatment options for MCI in aging males.
Main Methods:
- Review of basic science and epidemiological studies.
- Analysis of small prospective clinical trials on hormone replacement.
- Consideration of advanced neuroimaging techniques like PET scans.
Main Results:
- Hormonal replacement, particularly androgens, shows potential for improving cognitive function.
- Reported memory improvements in declarative and procedural domains.
- Functional and vascular brain changes may be detectable with advanced imaging.
Conclusions:
- Androgens may offer a future therapeutic strategy for MCI in aging males.
- Selective androgen receptor modulators (SARMs) are potential treatment options.
- Further research is warranted to confirm the efficacy of androgen-based therapies for cognitive decline.