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Age-Related Male Hypogonadism and Cognitive Impairment in the Elderly: Focus on the Effects of Testosterone Replacement Therapy on Cognition

1
Interdisciplinary Department of Medicine–Section of Internal Medicine, Geriatrics, Endocrinology and Rare Diseases. School of Medicine, University of Bari, Piazza Giulio Cesare 11, Policlinico of Bari, 70124 Bari, Italy
2
ASL Brindisi, Unit of Endocrinology, Metabolic Disease & Clinical Nutrition, Hospital “A. Perrino”, Strada 7 per Mesagne, 72100 Brindisi, Italy
3
Outpatients Clinic of Endocrinology and Metabolic Disease, Hospital “F. Jaja”, Via Edmondo de Amicis 36, Conversano, 70014 Bari, Italy
4
Department of Biomedical Sciences and Human Oncology, Section of Internal Medicine and Clinical Oncology, University of Bari Aldo Moro, Piazza Giulio Cesare 11, 70124 Bari, Italy
*
Author to whom correspondence should be addressed.
Geriatrics 2020, 5(4), 76; https://doi.org/10.3390/geriatrics5040076
Received: 31 August 2020 / Revised: 9 October 2020 / Accepted: 13 October 2020 / Published: 16 October 2020
(This article belongs to the Section Geriatric Endocrinology and Metabolic Disorder)
Background. Epidemiological data report that male hypogonadism may play a role in cognitive impairment in elderly. However, the effect of testosterone replacement therapy (TRT) on cognitive abilities in this cluster of patients has not been well established. Methods. PubMed/MEDLINE, Google Scholar, Cochrane Library, and Web of Science were searched by using free text words and medical subject headings terms related with “male hypogonadism”, “late-onset hypogonadism”, elderly, cognition, “mild cognitive impairment”, memory, “testosterone replacement therapy” used in various combinations according to the specific clinical questions. Original articles, reviews, and randomized controlled trials written in English were selected. Results. A long-term TRT could improve specific cognitive functions, such as verbal and spatial memory, cognitive flexibility, and physical vitality. However, randomized controlled trials do not provide positive results, and in most of the cases TRT might not induce beneficial effects on cognitive function in elderly men. Discussion and conclusions. Since the lengthening of life expectancy, the prevalence rate of cognitive decline in elderly men is expected to increase remarkably over the next decade with considerable healthcare and economical concerns. Therefore, this remains a relevant clinical topic and further investigations are needed for clarifying the role of TRT especially in elderly men with hypogonadism. View Full-Text
Keywords: late-onset hypogonadism; testosterone; testosterone replacement therapy; cognition; memory; mild cognitive impairment; review late-onset hypogonadism; testosterone; testosterone replacement therapy; cognition; memory; mild cognitive impairment; review
MDPI and ACS Style

Lisco, G.; Giagulli, V.A.; De Tullio, A.; De Pergola, G.; Guastamacchia, E.; Triggiani, V. Age-Related Male Hypogonadism and Cognitive Impairment in the Elderly: Focus on the Effects of Testosterone Replacement Therapy on Cognition. Geriatrics 2020, 5, 76.

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