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Effects of GH on cognitive function in elderly patients with adult-onset GH deficiency: a placebo-controlled 12-month study

Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Headington, Oxford OX3 7LJ, UK, ¹ Department of Endocrinology, University Hospital MAS, Malmö, Sweden, ² Worldwide Endocrine Care, Pfizer Inc, New York, USA, ³ Department of Pharmacology and Medicine, New York University School of Medicine, New York, USA and ⁴ CogState Ltd, Melbourne, Australia

(Correspondence should be addressed to J Wass; Email: john.wass{at}orh.nhs.uk)

Objective: Young adults with childhood-onset GH deficiency (GHD) have reduced memory and attention, which can be improved by treatment with GH. Little information is available on cognitive function in elderly GHD patients.

Design: Single center, double-blind, randomized, placebo-controlled study of 52-week duration.

Methods: Elderly GH therapy naïve GHD patients (n=34; age range 60–77 years) were enrolled and randomized to receive placebo or GH therapy which was titrated to achieve a target IGF-I level of +1 to +2 S.D. of the normal mean for age. Cognitive function was assessed at baseline and after 24 and 52 weeks, using a computerized psychometric test package (Neurobehavioral Examination System-2).

Results: The mean GH dose was 0.16±0.06 mg/day; mean IGF-I increased from 135±59 ng/ml at baseline to 213±77 ng/ml during active treatment. The GH-treated group had better mean serial digit learning scores compared with placebo group (P<0.05). Assessment of effect sizes showed that improvements in memory occurred with GH after 24 weeks. The overall adverse event rates were similar in the GH and the placebo group.

Conclusion: This study indicates that GH replacement may be accompanied by improvement in certain measures of cognitive function in elderly patients with GHD.