Lower serum testosterone concentrations are associated with a higher incidence of dementia in men: The UK Biobank prospective cohort study

Ross J. Marriott; Kevin Murray; Leon Flicker; Graeme J. Hankey; Alvin M. Matsumoto; Girish Dwivedi; Leen Antonio; Osvaldo P. Almeida; Shalender Bhasin; Adrian S. Dobs; David J. Handelsman; Robin Haring; Terence W. O'Neill; Claes Ohlsson; Eric S. Orwoll; Dirk Vanderschueren; Gary A. Wittert; Frederick C.W. Wu; Bu B. Yeap

doi:10.1002/alz.12529

Lower serum testosterone concentrations are associated with a higher incidence of dementia in men: The UK Biobank prospective cohort study

Ross J. Marriott, Kevin Murray, Leon Flicker, Graeme J. Hankey, Alvin M. Matsumoto, Girish Dwivedi, Leen Antonio, Osvaldo P. Almeida, Shalender Bhasin, Adrian S. Dobs, David J. Handelsman, Robin Haring, Terence W. O'Neill, Claes Ohlsson, Eric S. Orwoll, Dirk Vanderschueren, Gary A. Wittert, Frederick C.W. Wu, Bu B. Yeap

Endocrinology, Diabetes and Clinical Nutrition

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Introduction: The association of testosterone concentrations with dementia risk remains uncertain. We examined associations of serum testosterone and sex hormone–binding globulin (SHBG) with incidence of dementia and Alzheimer's disease. Methods: Serum total testosterone and SHBG were measured by immunoassay. The incidence of dementia and Alzheimer's disease (AD) was recorded. Cox proportional hazards regression was adjusted for age and other variables. Results: In 159,411 community-dwelling men (median age 61, followed for 7 years), 826 developed dementia, including 288 from AD. Lower total testosterone was associated with a higher incidence of dementia (overall trend: P =.001, lowest vs highest quintile: hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 1.13-1.81), and AD (P =.017, HR = 1.80, CI = 1.21-2.66). Lower SHBG was associated with a lower incidence of dementia (P <.001, HR = 0.66, CI = 0.51-0.85) and AD (P =.012, HR = 0.53, CI = 0.34-0.84). Discussion: Lower total testosterone and higher SHBG are independently associated with incident dementia and AD in older men. Additional research is needed to determine causality.

Original language	English (US)
Pages (from-to)	1907-1918
Number of pages	12
Journal	Alzheimer's and Dementia
Volume	18
Issue number	10
DOIs	https://doi.org/10.1002/alz.12529
State	Published - Oct 2022

ASJC Scopus subject areas

Epidemiology
Health Policy
Developmental Neuroscience
Clinical Neurology
Geriatrics and Gerontology
Cellular and Molecular Neuroscience
Psychiatry and Mental health

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10.1002/alz.12529

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Marriott, R. J., Murray, K., Flicker, L., Hankey, G. J., Matsumoto, A. M., Dwivedi, G., Antonio, L., Almeida, O. P., Bhasin, S., Dobs, A. S., Handelsman, D. J., Haring, R., O'Neill, T. W., Ohlsson, C., Orwoll, E. S., Vanderschueren, D., Wittert, G. A., Wu, F. C. W., & Yeap, B. B. (2022). Lower serum testosterone concentrations are associated with a higher incidence of dementia in men: The UK Biobank prospective cohort study. Alzheimer's and Dementia, 18(10), 1907-1918. https://doi.org/10.1002/alz.12529

Marriott, RJ, Murray, K, Flicker, L, Hankey, GJ, Matsumoto, AM, Dwivedi, G, Antonio, L, Almeida, OP, Bhasin, S, Dobs, AS, Handelsman, DJ, Haring, R, O'Neill, TW, Ohlsson, C, Orwoll, ES, Vanderschueren, D, Wittert, GA, Wu, FCW & Yeap, BB 2022, 'Lower serum testosterone concentrations are associated with a higher incidence of dementia in men: The UK Biobank prospective cohort study', Alzheimer's and Dementia, vol. 18, no. 10, pp. 1907-1918. https://doi.org/10.1002/alz.12529

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title = "Lower serum testosterone concentrations are associated with a higher incidence of dementia in men: The UK Biobank prospective cohort study",

abstract = "Introduction: The association of testosterone concentrations with dementia risk remains uncertain. We examined associations of serum testosterone and sex hormone–binding globulin (SHBG) with incidence of dementia and Alzheimer's disease. Methods: Serum total testosterone and SHBG were measured by immunoassay. The incidence of dementia and Alzheimer's disease (AD) was recorded. Cox proportional hazards regression was adjusted for age and other variables. Results: In 159,411 community-dwelling men (median age 61, followed for 7 years), 826 developed dementia, including 288 from AD. Lower total testosterone was associated with a higher incidence of dementia (overall trend: P =.001, lowest vs highest quintile: hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 1.13-1.81), and AD (P =.017, HR = 1.80, CI = 1.21-2.66). Lower SHBG was associated with a lower incidence of dementia (P <.001, HR = 0.66, CI = 0.51-0.85) and AD (P =.012, HR = 0.53, CI = 0.34-0.84). Discussion: Lower total testosterone and higher SHBG are independently associated with incident dementia and AD in older men. Additional research is needed to determine causality.",

author = "Marriott, {Ross J.} and Kevin Murray and Leon Flicker and Hankey, {Graeme J.} and Matsumoto, {Alvin M.} and Girish Dwivedi and Leen Antonio and Almeida, {Osvaldo P.} and Shalender Bhasin and Dobs, {Adrian S.} and Handelsman, {David J.} and Robin Haring and O'Neill, {Terence W.} and Claes Ohlsson and Orwoll, {Eric S.} and Dirk Vanderschueren and Wittert, {Gary A.} and Wu, {Frederick C.W.} and Yeap, {Bu B.}",

note = "Publisher Copyright: {\textcopyright} 2021 the Alzheimer's Association.",

year = "2022",

month = oct,

doi = "10.1002/alz.12529",

language = "English (US)",

volume = "18",

pages = "1907--1918",

journal = "Alzheimer's and Dementia",

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T1 - Lower serum testosterone concentrations are associated with a higher incidence of dementia in men

T2 - The UK Biobank prospective cohort study

AU - Marriott, Ross J.

AU - Murray, Kevin

AU - Flicker, Leon

AU - Hankey, Graeme J.

AU - Matsumoto, Alvin M.

AU - Dwivedi, Girish

AU - Antonio, Leen

AU - Almeida, Osvaldo P.

AU - Bhasin, Shalender

AU - Dobs, Adrian S.

AU - Handelsman, David J.

AU - Haring, Robin

AU - O'Neill, Terence W.

AU - Ohlsson, Claes

AU - Orwoll, Eric S.

AU - Vanderschueren, Dirk

AU - Wittert, Gary A.

AU - Wu, Frederick C.W.

AU - Yeap, Bu B.

PY - 2022/10

Y1 - 2022/10

N2 - Introduction: The association of testosterone concentrations with dementia risk remains uncertain. We examined associations of serum testosterone and sex hormone–binding globulin (SHBG) with incidence of dementia and Alzheimer's disease. Methods: Serum total testosterone and SHBG were measured by immunoassay. The incidence of dementia and Alzheimer's disease (AD) was recorded. Cox proportional hazards regression was adjusted for age and other variables. Results: In 159,411 community-dwelling men (median age 61, followed for 7 years), 826 developed dementia, including 288 from AD. Lower total testosterone was associated with a higher incidence of dementia (overall trend: P =.001, lowest vs highest quintile: hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 1.13-1.81), and AD (P =.017, HR = 1.80, CI = 1.21-2.66). Lower SHBG was associated with a lower incidence of dementia (P <.001, HR = 0.66, CI = 0.51-0.85) and AD (P =.012, HR = 0.53, CI = 0.34-0.84). Discussion: Lower total testosterone and higher SHBG are independently associated with incident dementia and AD in older men. Additional research is needed to determine causality.

AB - Introduction: The association of testosterone concentrations with dementia risk remains uncertain. We examined associations of serum testosterone and sex hormone–binding globulin (SHBG) with incidence of dementia and Alzheimer's disease. Methods: Serum total testosterone and SHBG were measured by immunoassay. The incidence of dementia and Alzheimer's disease (AD) was recorded. Cox proportional hazards regression was adjusted for age and other variables. Results: In 159,411 community-dwelling men (median age 61, followed for 7 years), 826 developed dementia, including 288 from AD. Lower total testosterone was associated with a higher incidence of dementia (overall trend: P =.001, lowest vs highest quintile: hazard ratio [HR] = 1.43, 95% confidence interval [CI] = 1.13-1.81), and AD (P =.017, HR = 1.80, CI = 1.21-2.66). Lower SHBG was associated with a lower incidence of dementia (P <.001, HR = 0.66, CI = 0.51-0.85) and AD (P =.012, HR = 0.53, CI = 0.34-0.84). Discussion: Lower total testosterone and higher SHBG are independently associated with incident dementia and AD in older men. Additional research is needed to determine causality.

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JO - Alzheimer's and Dementia

JF - Alzheimer's and Dementia

IS - 10

ER -

Lower serum testosterone concentrations are associated with a higher incidence of dementia in men: The UK Biobank prospective cohort study

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