Men's Midlife Issues -- Memory Loss, Depression and More

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Presented by Norman Berlinger, MD, at Men's Health 2010.

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Men's Midlife Issues -- Memory Loss, Depression and More

  1. 1. Norman T. Berlinger, M.D.,Ph.D.
  2. 2. <ul><li>LUNCHBOX </li></ul><ul><li>COWBOY </li></ul><ul><li>WHITEWASH </li></ul>
  3. 3. <ul><li>Memory Impairment </li></ul><ul><li>or </li></ul><ul><li>Where the hell are my glasses? </li></ul>
  4. 4. Statistics <ul><li>Two-thirds of older adults have some memory impairment, but for the most part it is minor. </li></ul><ul><li>One-third of older adults avoid most memory impairment associated with aging. </li></ul><ul><li>Aging men have poorer memories than aging women. </li></ul>
  5. 5. <ul><li>In most cases, memory loss does not signal the onset of serious illness or dementia. </li></ul>
  6. 6. Causes of Memory Impairment <ul><li>Elevated blood pressure </li></ul><ul><li>Elevated cholesterol </li></ul><ul><li>Obesity </li></ul><ul><li>Diabetes </li></ul><ul><li>Insomnia </li></ul><ul><li>Stress </li></ul><ul><li>Depression </li></ul><ul><li>Decreased Testosterone </li></ul><ul><li>Memory Self-Efficacy </li></ul>
  7. 7. <ul><li>The mind is like a muscle </li></ul><ul><li>Use it or lose it </li></ul>
  8. 8. Male Menopause <ul><li>Andropause </li></ul><ul><li>Manopause </li></ul><ul><li>Male Mental-Pause </li></ul><ul><li>Male Climacteric </li></ul><ul><li>ADAM (Androgen deficiency of the aging male) </li></ul><ul><li>LOH (Late onset hypogonadism) </li></ul>
  9. 9. <ul><li>Fact or Fiction? </li></ul>
  10. 10. Physical Symptoms <ul><li>Increased body fat </li></ul><ul><li>Decreased muscle bulk and strength </li></ul><ul><li>Swollen or tender breasts </li></ul><ul><li>Less Energy </li></ul><ul><li>Hot flashes </li></ul>
  11. 11. Emotional Changes <ul><li>Decreased motivation </li></ul><ul><li>Decreased self-confidence </li></ul><ul><li>Sadness or depression </li></ul><ul><li>Difficulty concentrating </li></ul><ul><li>Memory problems </li></ul>
  12. 12. Treatment <ul><li>Testosterone - by injection, patch, or gel </li></ul><ul><li>Not a tonic for vague complaints </li></ul>
  13. 13. When to Prescribe Testosterone <ul><li>Decreased sex drive </li></ul><ul><li>Erections less strong </li></ul><ul><li>Decreased strength or endurance </li></ul><ul><li>Lack of energy </li></ul><ul><li>Lost height </li></ul><ul><li>Decreased enjoyment of life </li></ul><ul><li>Sad and/or grumpy </li></ul><ul><li>Deterioration in sports ability </li></ul><ul><li>Falling asleep after dinner </li></ul><ul><li>Decreased work performance </li></ul>
  14. 14. <ul><li>Male Menopause </li></ul><ul><li>is not </li></ul><ul><li>Mid-Life Crisis </li></ul>
  15. 15. Mid-Life Crisis <ul><li>Life changes can precipitate a crisis </li></ul><ul><li>Struggles are at an end </li></ul><ul><li>New-found stability may signal an end to vitality and youth </li></ul><ul><li>Working towards goals of family and peers may turn out to be unfulfilling </li></ul><ul><li>Major shifts in career, marriage, parenting </li></ul><ul><li>Realization of impending old age, retirement, and eventual death </li></ul>
  16. 16. Depression – Major Symptoms <ul><li>Depressed mood </li></ul><ul><li>Anhedonia </li></ul>
  17. 17. Depression – Minor Symptoms <ul><li>Fatigue </li></ul><ul><li>Psychomotor retardation </li></ul><ul><li>Sleep disturbance </li></ul><ul><li>Appetite disturbance </li></ul><ul><li>Feelings of guilt </li></ul><ul><li>Loss of self-esteem, optimism </li></ul><ul><li>Suicide ideation </li></ul>
  18. 18. Additional Criteria <ul><li>Symptoms most every day for 2 weeks </li></ul><ul><li>Interferes with functioning </li></ul>
  19. 19. Dysthymia <ul><li>Every day is not black but gray </li></ul><ul><li>Mostly emotional and not physical symptoms </li></ul>
  20. 20. <ul><li>LUNCHBOX </li></ul><ul><li>COWBOY </li></ul><ul><li>WHITEWASH </li></ul>

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