Background and Purpose:

To investigate the association between testosterone levels and the risk of dementia and to assess the effectiveness of testosterone supplement treatment in patients with cognitive impairment or dementia.

Methods:

We searched Pubmed, Cochrane Library, and EMBASE on September 30, 2019.

Results:

The risk factor portion of the review included 27 studies with 18 599 participants. Studies revealed inconsistent findings on the association between testosterone levels and the risk of all-cause dementia or Alzheimer disease (AD). The result from our meta-analysis showed an increased risk of all-cause dementia with decreasing total testosterone (total-T, 4572 participants, hazard ratio: 1.14, 95% CI: 1.04-1.26). Some studies also found an increased risk of AD with a lower level of total-T, free testosterone, and bioavailable testosterone. Testosterone supplement treatment may improve general cognitive function and motor response in the short term as measured by the Developmental Test of Visual-Motor Integration (mean difference [MD]: 4.4, 95% CI: 1.20-7.59) and the Mini-Mental State Examination (MD: 3.4, 95% CI: 0.83-5.97) and verbal memory as measured by story recall delay at 3 months (MD: 8.4, 95% CI: 0.49-16.3).

Conclusion:

Lower levels of testosterone may be associated with an increased risk of all-cause dementia or AD. Testosterone supplement treatment may or may not improve general cognitive function in patients with cognitive impairment/AD.

中文翻译：

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中年或老年男性的睾酮和认知障碍或痴呆症：因果关系和干预，系统评价和荟萃分析。

背景和目的：

调查睾酮水平与痴呆风险之间的关联，并评估睾酮补充剂治疗认知障碍或痴呆患者的有效性。

方法：

我们于 2019 年 9 月 30 日检索了 Pubmed、Cochrane 图书馆和 EMBASE。

结果：

该评价的风险因素部分包括 27 项研究，涉及 18 599 名参与者。研究表明，关于睾酮水平与全因痴呆或阿尔茨海默病 (AD) 风险之间关联的研究结果不一致。我们的荟萃分析结果显示，随着总睾酮的降低，全因痴呆的风险增加（总 T，4572 名参与者，风险比：1.14，95% CI：1.04-1.26）。一些研究还发现，总 T、游离睾酮和生物可利用的睾酮水平较低会增加 AD 的风险。睾酮补充治疗可以在短期内改善一般认知功能和运动反应，如视觉运动整合发育测试（平均差异 [MD]：4.4，95% CI：1.20-7.59）和简易精神状态检查（MD：3.4，95% CI：0.83-5。

结论：

较低水平的睾酮可能与增加的全因痴呆或 AD 风险有关。睾酮补充剂治疗可能会或可能不会改善认知障碍/AD 患者的一般认知功能。