RESUMEN
CONTEXT: Little is known about the role of testosterone and estradiol on cognition in healthy older men. OBJECTIVE: The cognitive effects of increasing or lowering testosterone or estradiol were examined. DESIGN: Cognition was assessed before and after 6 wk of double-blind placebo-controlled hormone modification. SETTING: The study was conducted at an academic medical center. PARTICIPANTS: Healthy older (ages 60-80 yr) and younger men (ages 25-35 yr) were recruited from the community. INTERVENTION: Men were randomized to one of four treatments: 1) maintain testosterone and estradiol at eugonadal levels for young men (GnRH agonist + testosterone gel); 2) block testosterone's conversion to estradiol (GnRH agonist + testosterone gel + aromatase inhibitor); 3) induce hypogonadism (GnRH agonist alone); and 4) all placebo. MAIN OUTCOME MEASURES: Measures of executive function, memory, and spatial cognition were obtained before and after treatment. Hormone levels were obtained 10 times over the course of the study. RESULTS: Counter to expectations, hormone treatment did not affect cognition (P > 0.10). Free testosterone was positively related to spatial cognition in older men after treatment and controlling for age and estradiol level or exclusion of the hypogonadal men (P = 0.02). Estradiol was negatively associated with working memory controlling for the same variables (P = 0.01). Blinding to treatment assignment was maintained, with the exception of the hypogonadal group. CONCLUSIONS: A significant change in sex hormone status, including complete hypogonadism, does not modify cognition in men. These findings, along with studies that show a risk for neurodegenerative disease in those with low testosterone, suggest that sex hormone status may be important for neuroprotection in aging but not modulation of normal day-to-day cognitive function.
Asunto(s)
Cognición/efectos de los fármacos , Hormonas Esteroides Gonadales/farmacología , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento/efectos de los fármacos , Envejecimiento/fisiología , Cognición/fisiología , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Esquema de Medicación , Estradiol/administración & dosificación , Estradiol/farmacología , Hormonas Esteroides Gonadales/administración & dosificación , Hormona Liberadora de Gonadotropina/administración & dosificación , Hormona Liberadora de Gonadotropina/agonistas , Hormona Liberadora de Gonadotropina/farmacología , Humanos , Leuprolida/administración & dosificación , Leuprolida/farmacología , Masculino , Persona de Mediana Edad , Placebos , Testosterona/administración & dosificación , Testosterona/farmacología , Factores de TiempoRESUMEN
OBJECTIVE: To examine the association of cognitive function with sex steroid and sex hormone binding globulin (SHBG) levels among elderly men. DESIGN: Prospective cohort study, The Osteoporotic Fractures in Men Study (MrOS), consisting of 5995 US community dwelling men of 65 years or older. PATIENTS: One thousand six hundred and two men were chosen randomly from MrOS cohort for sex steroid level measurements by Mass Spectrometry (MS) at baseline. Two thousand six hundred and twenty-three MrOS participants with sex steroids measured using RIA were also examined. MEASUREMENTS: Baseline and follow-up (4.5 years later) performance on two cognitive tests: Trails B (executive function and motor speed) and 3MS (global cognitive function). Baseline total testosterone and oestradiol were measured by MS. Free testosterone (free-T) and free oestradiol (free-E) were calculated. SHBG was measured by radioimmunoassay. Data were analysed using linear regression. RESULTS: Baseline free-T and free-E levels were not associated with cognitive performance or change in cognition, following adjustment for age, education, race, health status and alcohol use. Baseline SHBG levels were inversely associated with follow-up trails B (P = 0.03) and 3MS performance (P = 0.02). Higher SHBG was associated with an increased risk of cognitive decline. Total sex steroid levels were not associated with cognitive performance. CONCLUSIONS: Despite large numbers of participants and rigorous sex steroid measurements, we did not observe an association between cognition and either testosterone or oestradiol levels. We conclude that endogenous sex steroids in the normal range are not related to executive function or global cognitive function in elderly men. High SHBG deserves further examination as a risk factor for cognitive decline.
Asunto(s)
Cognición/fisiología , Hormonas Esteroides Gonadales/sangre , Anciano , Humanos , Masculino , Estudios Prospectivos , Globulina de Unión a Hormona Sexual/análisisRESUMEN
We tested the structure and magnitude of genetic and environmental influences on the overlap among self-esteem, negative emotionality, and major depression symptoms in adolescent girls (N=706) from the Minnesota Twin Family Study. Genetic and environmental influences on all three operated via a general, heritable factor. Genetic influences explained the majority of overlap among the three constructs, as well as most of the variance in self-esteem and negative emotionality. Genetic influences on depression were more modest and largely due to genetic factors specific to depression. These findings support the theory that self-esteem, depression, and neuroticism represent aspects of a common temperamental core. The interrelations among the three constructs in mid-adolescence is consistent with their interrelations in adulthood.
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Conducta del Adolescente/psicología , Personalidad/genética , Psicología del Adolescente , Gemelos/genética , Adolescente , Depresión/genética , Femenino , Humanos , Determinación de la Personalidad/estadística & datos numéricos , Autoimagen , Medio SocialRESUMEN
We investigated the effects of age and gender on emotional perception and physiology using electrodermal skin conductance response (SCR) and examined whether SCR is related to subjective perceptions of emotional pictures. Older adults found pictures to be more positive and arousing than younger participants. Older women rated pictures more extremely at both ends of the valence continuum: they rated positive pictures more positively and negative pictures more negatively. Elders were less likely to show measurable SCRs. However, magnitude of SCRs when a response occurred did not differ between young and old. Subjective ratings of emotion correlated with physiological responses in younger participants, but they were unrelated in older participants. Thus, in older adults the perception of emotional events was disconnected from the physiological state induced by emotion.
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Envejecimiento , Concienciación/fisiología , Emociones/fisiología , Percepción/fisiología , Caracteres Sexuales , Antagonistas Adrenérgicos beta/farmacología , Adulto , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Concienciación/efectos de los fármacos , Emociones/efectos de los fármacos , Femenino , Respuesta Galvánica de la Piel/efectos de los fármacos , Humanos , Masculino , Percepción/efectos de los fármacos , Estimulación Luminosa , Reconocimiento en Psicología/efectos de los fármacos , Reconocimiento en Psicología/fisiología , Adulto JovenRESUMEN
Behavioral and physiological data suggest that the striatal dopaminergic system is important in the production and execution of sequential movements. Striatal function is also modulated by sex hormones, and previous studies show that estradiol is related to sequential movement in women. The authors examined whether sex hormones are involved in the production of sequential movement in healthy older and younger men. Testosterone was modified for a 6-week period such that levels in older men matched those of younger men, the conversion of testosterone to estradiol was blocked, the production of testosterone was blocked, or the men received no treatment (placebo). Sequential movement was measured before and after hormone treatment. Older men were slower and more accurate than younger men on the sequential movement task pre- and posttreatment. Hormone manipulation had no effect on movement speed. Hormone levels were not correlated with sequential movement performance in either older or younger men, suggesting that sex hormones do not modulate sequential movement in men, and hormone replacement may not restore a loss of sequential movement ability in elderly men or men with Parkinson's disease.
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Andrógenos/sangre , Estrógenos/sangre , Movimiento/fisiología , Testosterona/sangre , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Análisis de Varianza , Anastrozol , Andrógenos/administración & dosificación , Inhibidores de la Aromatasa , Hormona Liberadora de Gonadotropina/administración & dosificación , Humanos , Leuprolida/administración & dosificación , Masculino , Persona de Mediana Edad , Movimiento/efectos de los fármacos , Nitrilos/administración & dosificación , Radioinmunoensayo , Tiempo de Reacción/efectos de los fármacos , Análisis de Regresión , Testosterona/administración & dosificación , Factores de Tiempo , Triazoles/administración & dosificaciónRESUMEN
OBJECTIVE: To examine how menopausal symptoms and estrogen therapy (ET)-induced symptom relief affect cognition in early menopause. DESIGN: There were two components. Part 1 was a cross-sectional study of 37 healthy, recently postmenopausal women with diverse menopausal symptoms. Women were categorized as having low (n=20) or high symptoms (n=17) based on a validated symptom questionnaire. Women completed mood and sleep questionnaires and underwent cognitive testing, which included verbal memory, visual memory, emotional memory, and verbal fluency. Thirty-two of these women went on to part 2 of the study. Fourteen were randomly assigned to receive ET and 18 to receive placebo for 8 weeks. Before treatment and at 4 and 8 weeks, women completed the same measures as in part 1 of the study. RESULTS: High symptom women had more negative mood (P=0.01) and lower quality sleep (P<0.001) than low symptom women. Despite suffering from more menopausal symptoms, worse mood, and poorer sleep, women in the high symptom group performed the same on cognitive testing as women in the low symptom group. Women receiving ET had greater improvements in menopausal symptoms and sleep compared with those receiving the placebo (PAsunto(s)
Cognición/efectos de los fármacos
, Estradiol/administración & dosificación
, Terapia de Reemplazo de Estrógeno
, Sofocos/tratamiento farmacológico
, Menopausia/psicología
, Estudios Transversales
, Método Doble Ciego
, Estradiol/sangre
, Femenino
, Sofocos/sangre
, Sofocos/patología
, Humanos
, Persona de Mediana Edad
, Pruebas Neuropsicológicas
, Índice de Severidad de la Enfermedad
, Privación de Sueño
, Encuestas y Cuestionarios
, Resultado del Tratamiento
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The authors investigated how self-evaluation motives (self-enhancement, self-assessment, self-verification, self-improvement - and also self-diminishment and no information) shape self-knowledge preferences in male incarcerated juvenile offenders (IJOs). IJOs responded to questions on how much they would like to receive and actually received each of six types of feedback (positive, truthful, improving, consistent, negative and no feedback) from each of six sources (teachers, parents, siblings, best friend, girlfriend and behavioural specialists or psychologists). IJOs disliked negative feedback and the lack of feedback. They preferred truthful feedback to consistent feedback, and received truthful and positive feedback more frequently than improving feedback. Additionally, they received more negative or no feedback from parents than they would like. Finally, IJOs expressed a preference for receiving more improving feedback from their girlfriends than they did. The study highlights the interplay of self-evaluation motives in IJOs and opens up promising research and rehabilitation directions.
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Delincuencia Juvenil , Autoevaluación (Psicología) , Adolescente , Humanos , Masculino , Encuestas y Cuestionarios , Estados UnidosRESUMEN
PURPOSE: Little is known about the effect of androgen deprivation therapy on the brain despite the fact that sex steroid receptors are abundant in cortical brain regions that mediate memory and other cognitive functions. We characterized the impact of androgen deprivation and of subsequent estradiol therapy on the long-term and working memory of patients with prostate cancer. MATERIALS AND METHODS: Long-term memory (immediate and delayed paragraph recall tests), working memory (SOP and Trails tests) and Profile of Mood States were assessed at baseline and 4 weeks later in 18 patients with androgen independent prostate cancer beginning second line hormonal therapy with transdermal estradiol 0.6 mg/24 hours. The same assessments were performed in 2 age matched control groups of 18 patients with prostate cancer undergoing androgen deprivation continuing on hormonal therapy and 17 community dwelling healthy men. RESULTS: Immediate and delayed verbal memory were significantly worse in patients with prostate cancer on androgen deprivation than in age matched healthy controls. In addition, men with prostate cancer took more time to complete the Trails A task, indicating slower processing speed, but did not differ significantly from healthy controls in working memory tasks. In individual repeated measures analyses, verbal memory performance improved with estradiol therapy but did not change in the 2 control groups. CONCLUSIONS: Sex steroid loss and replacement have effects on specific cognitive processes in older men. Furthermore, estrogen has the potential to reverse the neurotoxic effects on memory performance caused by androgen deprivation.
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Afecto/efectos de los fármacos , Estradiol/farmacología , Memoria/efectos de los fármacos , Anciano , Antagonistas de Andrógenos/uso terapéutico , Humanos , Masculino , Neoplasias de la Próstata/tratamiento farmacológico , TestosteronaRESUMEN
Complementary approaches examined the relations among executive self, self-esteem, and negative affectivity. A cross-sectional (N = 4,242) and a longitudinal (N = 158) study established that self-esteem mediated the relation between executive self and negative affectivity. A 3rd study (N = 878 twin pairs) replicated this pattern and examined genetic and environmental influences underlying all 3 phenotypes. Covariation among the 3 phenotypes reflected largely common genetic influences, although unique genetic effects explained variability in both executive self and negative affectivity. Executive self was influenced by shared environmental influences unique from those affecting self-esteem and negative affectivity. Non-shared environmental influences accounted for the majority of variance in each construct and were primarily unique to each. The unique genetic and non-shared environmental influences support the proposition that the executive self, self-esteem, and negative affectivity capture distinct and important differences between people.
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Afecto , Cognición , Genotipo , Fenotipo , Autoimagen , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Encuestas y CuestionariosRESUMEN
Androgen deprivation leads to a profound loss of synaptic density in the hippocampus and changes in learning and memory in animal models. The authors examined group differences in verbal memory between men on androgen deprivation therapy (ADT), a commonly used treatment for prostate cancer, and healthy men. The authors found that men on ADT have a specific impairment of retention but normal encoding and retrieval processes on a word list-learning task. Speed and accuracy for both perceptual and semantic encoding, as well as retrieval at a very short retention interval, were not affected; however, recognition fell to chance after a 2-min retention interval in men on ADT. Healthy men showed only moderate forgetting, and performance was still above chance at 12 min. This pattern of preserved encoding and retrieval but impaired retention suggests that androgens play a role in hippocampally mediated memory processes, possibly having a specific affect on consolidation.