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Testosterone doesn't improve QOL
or cognition in men with AD
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Clinical Question:
Does testosterone improve quality of life or cognitive function in men with
Alzheimer's disease?
Bottom Line:
Results suggest that testosterone replacement therapy improved overall
quality of life in patients with AD. Testosterone had minimal effects on
cognition.
Reference:
Lu PH, Masterman DA, Mulnard R, et al. Effects of testosterone on cognition
and mood in male patients with mild Alzheimer disease and healthy elderly
men. Arch Neurol 2006;63:177-85. |
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Study Design:
Randomized controlled trial (double-blinded)
Synopsis:
There is a compelling need for therapies that prevent, defer the onset, slow
the progression, or improve the symptoms of Alzheimer disease (AD). To
evaluate the effects of testosterone therapy on cognition, neuropsychiatric
symptoms, and quality of life in male patients with mild AD and healthy
elderly men. Twenty-four-week, randomized, double-blind, placebo-controlled,
parallel-group study. Memory disorders clinics as well as general neurology
and medicine clinics from University of California medical centers at Los
Angeles, San Francisco, and Irvine. Sixteen male patients with AD and 22
healthy male control subjects. Healthy elderly control men were recruited
from the community through advertisements as well as through the
university-based clinic. Testosterone and placebo, in the form of
hydroalcoholic gel (75 mg), were applied daily to the skin of the
participants. Instruments assessing cognitive functioning (Alzheimer's
Disease Assessment Scale-Cognitive Subscale, California Verbal Learning
Test, Block Design Subtest, Judgment of Line Orientation, Developmental Test
of Visual-Motor Integration), neuropsychiatric symptoms (Neuropsychiatric
Inventory), global functioning (Clinician's Interview-Based Impression of
Change), and quality of life (Quality of Life-Alzheimer Disease Scale). For
the patients with AD, the testosterone-treated group had significantly
greater improvements in the scores on the caregiver version of the
quality-of-life scale (P = .01). No significant treatment group differences
were detected in the cognitive scores at end of study, although numerically
greater improvement or less decline on measures of visuospatial functions
was demonstrated with testosterone treatment compared with placebo. In the
healthy control group, a nonsignificant trend toward greater improvement in
self-rated quality of life was observed in the testosterone-treated group (P
= .09) compared with placebo treatment. No difference between the treatment
groups was detected in the remaining outcome measures. Testosterone
treatment was well tolerated with few adverse effects relative to placebo. |
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