Association between testosterone and cognitive performance in postmenopausal women: a systematic review of observational studies

Abstract

This review was conducted to explore the association between endogenous testosterone blood concentrations and cognitive performance among community dwelling postmenopausal women. We searched Ovid MEDLINE, EMBASE, PsycINFO and Web of Science databases for observational studies with at least 100 postmenopausal participants. The results were categorized by study design, reporting of total or free testosterone and risk of bias assessments, narratively. Ten of the 26 articles retrieved for full-text review met the inclusion criteria, six provided cross-sectional data, seven provided longitudinal data and one provided case–control data. Cognitive performance tests differed between studies. Eight studies measured testosterone by immunoassay, one by liquid chromatography-tandem mass spectrometry (LC-MS/MS) and one did not specify their methodology. Eleven different cognitive domains were tested by 37 different instruments. Irrespective of the study design, the findings were inconsistent and inconclusive. Both positive and inverse associations were reported for each of global cognition and immediate and delayed verbal recall. The majority of studies reported no association between total or free testosterone and cognitive performance. Although this review did not demonstrate an association between testosterone and cognitive performance in postmenopausal women, the findings should be considered inconclusive due to the imprecision of testosterone measurement and the methodological heterogeneity of the included studies.

摘要

本研究旨在探讨社区绝经后妇女的内源性血睾酮浓度与认知能力之间的关系。我们搜索了Ovid Medline、Embase、PsycInfo和Web of Science数据库, 对至少100名绝经后参与者进行了观察性研究。结果叙述性地按研究设计、总睾酮或游离睾酮的报告和偏倚评估的风险进行分类。全文检索26篇文献中10篇符合纳入标准, 6篇提供横断面资料, 7篇提供纵向资料, 1篇提供病例对照资料。认知能力测试在不同的研究中有所不同。八项研究用免疫分析法测定睾酮, 一项用液相色谱-串联质谱（LC-MS/MS）测定, 一项没有具体说明其方法学。 11个不同的认知域被37种不同的仪器测试。无论研究设计如何, 研究结果都是不一致和不确定的。 整体认知与即时记忆和延迟记忆的正相关和反相关都被报道。 大多数研究报告总睾酮或游离睾酮与认知能力之间没有联系。尽管这篇综述没有证明绝经后妇女睾酮与认知能力之间的联系, 但由于睾酮测量的不精确性和纳入研究的方法异质性, 这些发现应该被认为是不确定的。

Keywords:

• Postmenopause
• testosterone
• androgen
• dementia
• cognitive function
• cognitive performance

Potential conflict of interest

F.S. is the recipient of the Monash Graduate Scholarship and Monash International Tuition scholarship. S.R.D. reports unrelated support including grants from the NHMRC Australia; honoraria for educational activities from Besins Healthcare, Abbott, BioFemme, Biosyent, Theramex and Mayne Pharma; personal Advisory Board/consultancy fees from Theramex, Gedeon Richter Abbott, Astellas, Mayne Pharma, Roche Diagnostics, Lawley Pharmaceuticals and Que Oncology; and has received institutional grant funding from Que Oncology and Ovoca research. R.M.I. has received support from Lawley Pharmaceuticals for conference attendance. All other authors have no potential conflicts of interest to declare.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors. F.S. holds a Monash University Graduate Research Scholarship; S.R.D. is an NHMRC Senior Principal Research Fellow [Grant No. 1135843].