Associations between declining testosterone concentrations and cognitive performance in community-dwelling older Australian women: a prospective cohort study.

Testosterone may have a role in brain health. Whether older women who exhibit a decline in blood testosterone are at an increased risk of cognitive decline is uncertain. A subset of Australian female participants in the Aspirin in Reducing Events in the Elderly (ASPREE) trial had testosterone concentrations measured by liquid chromatography-tandem mass spectrometry and underwent a comprehensive cognitive test battery at baseline and study year 3. Cognitive decline was defined as a lower test score at year 3 compared with baseline. The mean change (baseline to year 3) of testosterone concentration was examined by paired-sample t-test. Stable or increased (reference) versus a decline in testosterone concentration was used to investigate the association with cognitive decline using logistic regression. A total of 395 women (median [interquartile range] age 78.1 [73.7-82.3] years) provided data for analysis. In total, 154 women (39%) had a decline in blood testosterone which was not associated with a decline in any cognitive measure (Modified Mini-Mental State Examination: odds ratio [OR] = 0.96, 95% confidence interval [CI] 0.63 to 1.49, p = 0.86; Hopkins Verbal Learning Test - Revised: Immediate Recall, OR = 0.71, 95% CI 0.44 to 1.13, p = 0.151 and Delayed Recall, OR = 1.42, 95% CI 0.89 to 2.26, p = 0.14; Controlled Oral Word Association Test: OR = 0.79, 95% CI 0.49 to 1.25, p = 0.31; and Symbol Digit Modalities Test: OR = 0.83, 95% CI 0.53 to 1.29, p = 0.40). Limiting the analysis to 237 women aged 70-79 years (74.5 [interquartile range 72.2-77.1] years), no association was observed between a decline in blood testosterone and any cognitive outcome. : A decline in blood testosterone concentrations over 3 years was not associated with a decline in cognitive function in community-dwelling Australian women aged 70 years and older.