Testosterone Can Worsen Aggression in Alzheimer's

In men with Alzheimer’s disease, having higher levels of testosterone could increase the risk for aggression, hallucinations and other acting-out behaviors, according to a new study at the University of North Texas Health Science Center.

Previous research has shown that having higher testosterone levels actually lowers the risk for developing Alzheimer’s, but once a person has the disease, testosterone can exacerbate certain symptoms.

“Once someone already has Alzheimer’s, higher levels of testosterone are related to acting-out behaviors,” said Dr. James Hall, professor of psychiatry and behavioral health. “Those behaviors, such as agitation and delusions, occur at some point in at least 70 percent of Alzheimer’s patients.”

The study raises concerns about the increasingly common practice of putting older men on testosterone-replacement therapy, noted Hall.

“What we’re showing is that testosterone can have a negative impact on patients with Alzheimer’s disease,” he said. “It may be crucial to consider the possible unintended consequences before a patient is placed on testosterone-replacement therapy.”

Alzheimer’s is a form of dementia that affects a person’s thinking, judgment, memory, language and behavior. It currently comes in sixth on the list of leading causes of death in the United States according to the Centers for Disease Control and Prevention (CDC).

At present, there is no cure for Alzheimer’s disease, which affects approximately five million Americans. Researchers at University of North Texas Health Science Center are conducting studies to better understand the disease; their goal is to discover more effective ways to manage and treat the illness and eventually find a cure.

For the study, researchers evaluated 87 elderly men who were diagnosed with mild to moderate Alzheimer’s disease. The researchers found that the likelihood of experiencing hallucinations was 5.5 times greater for the men with higher levels of testosterone than those with lower levels.

These acting-out behaviors become very problematic and are often especially difficult for caregivers to manage.

“It can be extremely stressful, both physically and psychologically, to care for the person at home,” Hall said. “Acting-out behaviors are the most frequent reason for placement in a nursing home or institutionalized setting.”

More research is needed to confirm the connection between testosterone and these acting-out behaviors, said Hall. His hope is that the research will lead to better ways to identify at-risk patients and thus develop early interventions, he said. In that case, specific treatments to address these behaviors could be developed.

Source: UNT Health Science Center