(281) TESTOSTERONE DEFICIENCY AND RISK OF COGNITIVE DISORDERS IN AGING MALES:RESULTS FROM A META-ANALYSIS STUDY

Abstract Objectives The aim of the present study is to systematically meta-analyze and discuss all the available evidence regarding the possible role of Testosterone replacement therapy (TRT) in age-depended male cognition impairment and dementia. Methods A comprehensive Medline, Embase and Cochrane search was performed including the following words: [“testosterone”[MeSH Terms] OR “testosterone”[All Fields]] AND [“cognition”[MeSH Terms] OR “cognition”[All Fields]]. All placebo-controlled trials evaluating the effect of TRT on several cognition outcomes without any restriction were included. Since the classification of tests into cognitive domains differed among the included studies, the available neuropsychological tests were divided into seven cognitive domains, based on an established neuropsychological reference text as previously reported. In order to obtain more comparable results, only trials with homogenous cognitive tests were analyzed. Results Overall, 17 studies were available including 1438 patients with a mean age of 70.4 years and a mean follow-up of 45.6 weeks. These trials differ in basal TT levels and type of T preparation used. In addition, nine were performed in aging men without memory problems, five in subjects with mild to moderate cognitive impairment and two in patients with Alzheimer’s disease. When TRT was compared to placebo, no difference in all the cognitive domains analyzed was observed. In addition, no differences were also observed when depressive symptoms or score derived from Mini-Mental State Examination test were considered or when only patients with cognitive impairment were considered. Conclusions Present data did not support the use of TRT for the improvement of several cognitive domains analyzed including attention/working memory, executive function, language, verbal memory, visual memory, visuomotor ability, and visuospatial ability. However, it is important to recognize that the vast majority of available RCTs included mixed populations of subjects with eugonadism and hypogonadism preventing any final conclusions Conflicts of Interest No conflict of interest to declare.