Higher serum free testosterone is associated with better cognitive function in older men, while total testosterone is not. The Health In Men Study
Abstract
Summary: Objective To determine the relationship of total and free serum testosterone to cognitive performance in older men. Design Cross‐sectional study of a population‐based sample. Participants A total of 2932 men aged 70–89 years. Measurements Cognitive function was assessed using the Standardized Mini‐Mental State Examination (SMMSE). Early morning sera were assayed for total testosterone, SHBG and LH. Free testosterone was calculated using the Vermeulen method. Results There were weak positive correlations between SMMSE score and serum free testosterone (Spearman's rho = 0·06, P = 0·001) and total testosterone (r = 0·04, P = 0·027), and a weak negative correlation with LH (r = −0·07, P < 0·001). Men with SMMSE scores in the top quintile had higher serum free testosterone compared with those in the lowest quintile [median (interquartile range, IQR): 278 (228–335) vs. 262 (212–320) pmol/l, P = 0·003], but similar total testosterone [15·2 (11·9–18·8) vs. 14·8 (11·6–18·3) nmol/l, P = 0·118]. Increasing age, non‐English‐speaking background, lower educational attainment, presence of clinically significant depressive symptoms, and cardiovascular morbidity were associated with the lowest cognitive performance quintile. After their effects were taken into account in a multivariate analysis, serum free testosterone ≥ 210 pmol/l was associated with reduced likelihood of poor cognitive performance on the SMMSE [odds ratio (OR) 0·71, 95% confidence interval (CI) 0·52–0·97]. Conclusions In community‐dwelling older men, serum free testosterone ≥ 210 pmol/l is associated with better cognitive performance. In this context, calculated free testosterone seems to be a more informative measure of androgen status than total testosterone. Studies examining the contribution of androgens to age‐related cognitive decline should incorporate an assessment of free testosterone concentration.
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Calculated free T is positively associated with cognitive performance, independent of age, mood, and physical comorbidity.
“An Australian cross-sectional study in 2932 men, aged 70 to 89 years, unveiled that calculated free T levels are positively associated with cognitive performance, independent of age, mood and physical comorbidity [234].”
From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [234]
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References 49 · Cited by 65
- Authors
- Yeap, B. B., Almeida, O. P., Hyde, Z., Chubb, S. A. P., Hankey, G. J., Jamrozik, K., & Flicker, L.
- Affiliations
- The University of Western Australia (AU)
- Fremantle Hospital (AU)
- The University of Queensland (AU)
- Royal Perth Hospital (AU)
- Corresponding author
- Yeap, Bu B.
- Venue
- Clinical Endocrinology
- Publisher
- Wiley
- Published
- 2007-09-03
- Volume
- 68
- Issue
- 3
- Pages
- 404-412
- ISSN
- 0300-0664 (ISSN-L)
- 1365-2265
- OpenAlex
- W1973035556
- Cited by
- 65
- References
- 49
- Citations by year
- 2026: 1 · 2024: 4 · 2022: 4 · 2021: 4 · 2020: 2 · 2019: 1 · 2018: 8 · 2017: 3 · 2016: 4 · 2015: 1 · 2014: 5 · 2013: 3 · 2012: 2
- FWCI
- 4.87
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Endocrinology (publishedVersion)
- PubMed (publishedVersion)
- UWA Profiles and Research Repository (University of Western Australia) (submittedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Funders
- Sylvia and Charles Viertel Charitable Foundation
- National Health and Medical Research Council
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
- Keywords
- free testosterone, total testosterone, cognitive function, older men, androgens, age-related cognitive decline, luteinizing hormone, sex hormone-binding globulin, Mini-Mental State Examination, depressive symptoms, cardiovascular morbidity, educational attainment
- MeSH terms
- Aged, Aged, 80 and over, Cognition, Cross-Sectional Studies, Humans, Male, Testosterone, Men's Health
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