Andrology Center, Department of Urology, Institute of Urology, 26447Peking University First Hospital, Beijing, China.
Department of Evidence Based Medicine and Clinical Epidemiology, 34753West China Hospital, Sichuan University, Chengdu, China.
J Geriatr Psychiatry Neurol. 2021 Sep;34(5):405-417. doi: 10.1177/0891988720933351. Epub 2020 Jun 30.
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.
We searched Pubmed, Cochrane Library, and EMBASE on September 30, 2019.
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).
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.
探讨睾酮水平与痴呆风险的相关性，并评估睾酮补充治疗对认知障碍或痴呆患者的疗效。
我们于 2019 年 9 月 30 日检索了 Pubmed、Cochrane Library 和 EMBASE。
综述的风险因素部分包括 27 项研究，共 18599 名参与者。研究结果表明，睾酮水平与全因痴呆或阿尔茨海默病（AD）风险之间的关联不一致。我们的荟萃分析结果显示，总睾酮（总-T）水平降低与全因痴呆风险增加相关（4572 名参与者，危险比：1.14，95%可信区间：1.04-1.26）。一些研究还发现，总-T、游离睾酮和生物可利用睾酮水平较低与 AD 风险增加相关。睾酮补充治疗可能在短期内改善一般认知功能和运动反应，表现为视觉运动整合发育测试（平均差异 [MD]：4.4，95%可信区间：1.20-7.59）和简易精神状态检查（MD：3.4，95%可信区间：0.83-5.97）得分升高，以及故事回忆延迟 3 个月时的言语记忆改善（MD：8.4，95%可信区间：0.49-16.3）。
较低的睾酮水平可能与全因痴呆或 AD 的风险增加有关。睾酮补充治疗可能改善认知障碍/AD 患者的一般认知功能，但也可能无效。
