Dementia in Men: Understanding Testosterone's Protective Effects on the Brain

The male hormone testosterone has a multitude of important functions in the human body. However, given the link between testosterone and aging, men usually experience a change in their testosterone levels after reaching middle age.

With age also come an array of changes, including potential effects on your brain function and volume. Low testosterone has hence been associated with brain fog, memory loss, and the alteration of cognitive abilities.

While dementia in men is not as common as in women, it remains a concern nonetheless. With Alzheimer’s disease being particularly prevalent, the question remains if there are lifestyle choices that could be cascading your Alzheimer’s risk or whether low testosterone could potentially contribute to dementia.

Let’s explore this topic in-depth — here’s everything you need to know about the link between testosterone and aging.

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The Link Between Testosterone and Aging

It’s true that your testosterone levels can vary significantly throughout your lifetime because of a strong link between testosterone and age. For most men, testosterone levels peak in their early twenties and then gradually decline as they get older.

This decline has been quantified at about 1.6% for total serum testosterone and 2% to 3% for free and bioavailable testosterone every year. Now what does that have to do with your cognition and brain function?

See, much of today’s research data suggests that cognitive skills and mood in men diagnosed with testosterone deficiency can improve when on testosterone therapy. Testosterone thus seems to play an important role in the ventral processing stream and presumably supports spatial cognition.

With testosterone decreasing with age, your cognitive function becomes more vulnerable, potentially impacting your memory, causing brain fog and depression, and affecting your mood.

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Dementia in Men

According to the CDC, about 4% of adults aged 65 or older have received a dementia diagnosis in the past. While dementia affects both men and women, women are at a slightly higher risk with 4.2% being diagnosed versus 3.8% of dementia in men.

The Alzheimer’s Association describes dementia as an umbrella term used for an array of cognitive issues that can complicate your day-to-day and threaten your independence. Some of the cognitive abilities that may be impacted constitute memory, problem-solving skills, and language. While dementia can have a multitude of causes, it’s most frequently triggered by Alzheimer’s.

Dementia in men can be displayed in various ways, with symptoms leading to a reduction in cognitive ability. Changes in your short-term memory and remembering tasks, appointments, or other aspects of your daily routine can all be indicators of dementia.

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What is Alzheimer’s Disease?

Alzheimer’s disease is by far the most widely spread form of dementia and as such is responsible for up to 80% of dementia cases. Dementia in men is primarily caused by damage incurred on the cellular level, whereby brain cells lose the ability to effectively communicate. In the process, cognitive skills like language, emotions, and thought processes can be affected.

While there are things that can cascade Alzheimer’s risk, a review determined that it is evident that hormone replacement therapy (HRT) and dementia are interconnected, establishing that hypogonadal men (men with low T) diagnosed with Alzheimer’s disease, responded well to hormone replacement therapy — thus showing improvement in both cognitive skills and memory.

As research has progressed quite a bit, today a biomarker for neurodegenerative diseases, referred to as Tauopathies, has been established as blood-based Tau (Tauopathies include Alzheimer’s disease). This biomarker can support a swifter diagnosis and can promote a reliable prognosis of future disease outcomes.

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Cascading Alzheimer’s Risk

In the U.S. alone, roughly 6.9 million people are living with Alzheimer’s disease according to data by the Alzheimer’s Association. The CDC warns that this number will grow exponentially over the next few years, requiring more healthcare resources to be allocated to people in need. But why is this happening and what is cascading Alzheimer’s risk?

While genetic predisposition plays a role in developing Alzheimer’s, we also find ourselves at the mercy of environmental factors and lifestyle, both of which are important players as well.

Alcohol consumption is a top-tier player as it has been identified that even moderate amounts of alcohol intake during midlife can lead to long-term changes in your brain. With alcohol able to impact brain glutamate signaling and able to cause inflammation it can increase your risk of dementia.

Chronic stress, all too common in today’s world, is further cascading Alzheimer’s risk but the risk is worsened even more if alcohol is used as a coping mechanism to “offset” stress — leading to now two factors that can trigger Alzheimer’s simultaneously.

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Low Testosterone and Dementia in Men

Given the link between testosterone and aging, it comes as no surprise that low testosterone can have adverse effects on your cognitive abilities, including memory and your ability to focus. 

For optimal performance, the male brain requires an array of healthy “fuels,” including sufficient levels of testosterone in your bloodstream. As we age, and testosterone begins its natural decline, your brain may begin to experience waves of neurodegeneration, which can lead to a reduction in brain function.

Extensive research has been done to investigate the differences between men with Alzheimer’s disease or other forms of dementia, including identifying biomarkers, examining hormone levels, and exploring genetic factors. Studies suggest that men with Alzheimer’s tend to have lower levels of testosterone and that vice versa, men on testosterone replacement therapy can perform better cognitively.

Some trials conducted on middle-aged and older men, for example, showed that those men with lower testosterone levels had a higher chance of developing dementia and cognitive issues.

While a lot more research is needed to validate findings, especially in case-controlled studies, most research to date points at testosterone therapy being able to improve cognitive skills in patients with Alzheimer’s disease. Hormone replacement therapy or HRT and dementia are, therefore, closely linked and testosterone therapy could potentially evolve into a clinical therapy aiding in the reduction of dementia development.

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Keep Your Testosterone Levels in Check

To avoid cascading your risk for Alzheimer’s and in order to stay healthy and keep your hormones in balance, ensure your primary care provider, urologist, or endocrine specialist monitors your testosterone levels — especially if you’re above age 40.

After all, testosterone can help keep you healthy and support countless aspects of your health. 

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