Partial androgen deficiency and neuropsychiatric symptoms in aging men

The partial androgen deficiency of aging males (PADAM) is responsible for a variety of behavioral symptoms, such as weakness, fatigue, decreased libido, depressive mood, lack of motivation and energy, lower psychological vitality, anxiety, irritability, insomnia, decreased work and sport performances, difficulty in concentrating, memory impairment and low dominance. Psychological and behavioral aspects of PADAM overlap with signs and symptoms of major depression. The evidence of the association between testosterone (T) level and male depression comes from studies that have assessed: 1) depression in hypogonadal subjects; 2) the relationship between T level and male depressive illness, and 3) the antidepressant action of androgen replacement. In humans, the role of androgens has been described, albeit inconsistently, in the regulation of sexuality, aggression, emotion and personality. These direct effects appear to be greatly influenced by social factors as well. Sex hormones are important for the development and maintenance of acquired cognitive abilities. Hormonal changes in androgen levels in older men modulate, at least in part, the cognitive changes of aging. Treatment with androgen hormones in hypogonadal men has shown an improvement in cognitive, verbal and visual memory, mental status, visuomotor scanning and attention, verbal knowledge/language, spatial abilities and memory for both verbal and visual information. The etiology of the behavioral symptoms of PADAM is multifactorial, being the result of the interaction of biological and social changes, and of the personal ability to adapt to the numerous individual and social changes that take place during mid-life transition.