Aging brings on a host of concerns, and arguably, none is more powerful than the fear of developing Alzheimer’s disease or another form of dementia. No one wants to spend the end of their lives robbed of memory and completely dependent on caregivers. The good news is that it is possible that testosterone therapy may prove protective against Alzheimer’s disease. This potential therapy is coming none too soon, as the U.S. is on the brink of a tremendous increase in the disease.
Alzheimer’s Disease
The Centers for Disease Control describes Alzheimer’s disease as a progressive disease that begins with mild memory loss and may lead to the inability to carry on a conversation or respond to the environment.
One out of every three seniors dies with Alzheimer’s or another form of dementia, according to the Alzheimer’s Association. It actually kills more people than breast cancer and prostate cancer combined.
Currently, about 6 million Americans are living with Alzheimer’s, but as the Baby Boomer generation ages, that number is expected to grow to nearly 13 million in less than 30 years. Between 2019 and 2020, deaths from heart disease declined by over 7 percent, but deaths from Alzheimer’s disease increased an astounding 145 percent. Nearly 75 percent of those with Alzheimer’s are age 72 or above. Beyond age 65, the number of people with the disease doubles every five years. About one-third of those over age 85 have Alzheimer’s.
What causes Alzheimer’s disease is not fully understood. However, it is not a normal part of aging. Genetics may play a role in some patients. Researchers suspect diet, environmental and lifestyle factors may contribute to the disease. Consuming a healthy diet and staying physically, mentally, and socially active may lower the risk of developing Alzheimer’s disease.
Low Testosterone and Alzheimer’s Disease
Sex hormones such as testosterone in men and estrogen in women can affect brain function positively. A study published in the May 2016 edition of Molecular Neurobiology found that “low plasma testosterone level is significantly associated with increased risk of Alzheimer’s disease in the elderly men,” and low testosterone levels are risk factors for worsening cognitive functioning in older males.
An earlier study conducted at the University of Hong Kong followed 153 Chinese men recruited from social centers. All the men lived in the community, were not exhibiting signs of dementia, and were aged 55 and older. However, 47 of the participants were showing signs of mild cognitive impairment. This involved some memory loss and issues with clear thinking.
Within 12 months of the start of the study, 10 of the men with mild cognitive impairment did develop what was likely Alzheimer’s disease. These individuals all had low levels of testosterone. What they also had in common was high blood pressure and elevated levels of the ApoE 4 (apolipoprotein E) protein. This protein is known to correlate with a greater risk for Alzheimer’s disease.
Modest Improvement
In an Australian study, 44 older men with “subjective memory complaint” and low to low-normal testosterone levels received short-term supplemental testosterone. The men were subject to a battery of neuropsychological tests to establish a baseline. They were then randomly assigned to two groups. Group A received 24 weeks of testosterone therapy, followed by four weeks of “washout,” and then 24 weeks receiving a placebo. Group B revered the treatment in reverse order, starting with the placebo and ending with testosterone supplementation.
Group A experienced a 1 point improvement in general cognitive functioning using the Mini Mental State Examination (MMSE) after treatment with testosterone. Similar scores with this group were found when comparing post-testosterone testing with post-placebo testing. However, Group B showed a significant increase from baseline after testosterone treatment and trended toward an increase after placebo treatment. No difference in baseline depression scores were observed in either group.
Overall, the results showed a modest global cognition improvement after testosterone therapy. Researchers noted that larger clinical trials are necessary for a conclusive determination regarding testosterone treatment significance.
Low Testosterone Causes
While aging is the primary driver of low testosterone, it is not the only culprit. By the age of 30, a man’s testosterone production decreases roughly 1 percent annually. Obese, younger men often have below-average testosterone levels.
Conditions such as hemochromatosis, or excess iron storage in the body, can cause testosterone levels to drop. Any trauma to the testicles can affect the body’s ability to create testosterone, and the same holds true for steroid use. Cancer survivors undergoing chemotherapy or radiation may lose testosterone.
Some medications can reduce testosterone levels. Inform your doctor about any medication or supplements you take, whether prescription or over-the-counter.
Symptoms of Low Testosterone
Cognitive impairment or memory loss are symptoms associated with low testosterone, along with early signs of dementia. Other symptoms of low testosterone include:
- Depression
- Breast enlargement, or gynecomastia
- Erectile dysfunction
- Hair thinning or loss
- Insomnia
- Loss of bone or muscle mass
- Loss of libido
- Weight gain, especially around the abdomen
Men and Alzheimer’s Disease
Women are more likely to develop Alzheimer’s disease than men. One reason is the loss of estrogen after menopause, which may offer protective effects. In contrast, men continue producing testosterone throughout their lives, although production does diminish as they age.
Testosterone Therapy Side Effects and Contraindications
Although men want to protect themselves against developing Alzheimer’s, not all are candidates for testosterone treatment. This therapy is not suited for men with prostate or other cancers, a history of cardiovascular disease, diabetes, or kidney or liver disease. The same holds true for those diagnosed with sleep apnea.
Side effects are also a possibility in some men. Potential side effects include:
- Acne
- High red blood cell counts — increasing clotting risks
- Edema, or swelling, in the ankles
The doctor may adjust the dosage for symptom relief.
Testosterone and Alzheimer’s Disease
While there is no guarantee that testosterone therapy can prevent Alzheimer’s disease in the individual patient, studies do hold promise. Men interested in testosterone therapy and whether it could benefit them should schedule a consultation with their doctor.
