Objective: Depression in aging men has been related to low sex hormone concentrations; the putatively modulating effects of the genetically determined androgen receptor (AR) cytosine-adenosine-guanine (CAG) repeat polymorphism are often not taken into account. The aim of this study was to determine how sex hormone levels and the AR polymorphism relate to depressive symptoms in aging men.
Methods: This cross-sectional study of men aged 50 years and older included 120 consecutive patients of the Department of Psychosomatics and Psychotherapy, 76 consecutive patients of the Andrologic Clinic, and 100 participants from the community sample (CS); all participants completed the Patient Health Questionnaire. Morning blood samples were analyzed for total and free testosterone, estradiol, and the AR CAG polymorphism. Patients on hormone substitution or other medication known to influence testosterone levels were excluded.
Results: The two clinical samples had significantly longer AR CAG repeats and higher depression levels compared with the CS. When controlling for possible confounders, depression scores were positively correlated with CAGn (r = 0.20, df: 107, p ≤ 0.038) in psychosomatic patients and with CAGn (r = 0.27, df: 55, p ≤ 0.043) and estradiol (r = 0.31, df: 55, p ≤ 0.019) in andrologic patients, whereas the CS showed no significant correlations between depression scores, CAGn, and sex hormones. CAGn did not correlate significantly with testosterone in the three samples. Regression analysis confirmed association of CAGn with depression.
Conclusions: Conclusions from these data must be considered to be preliminary and need to be replicated. However, our results point to associations between the genetic AR polymorphism and vulnerability to depressive symptomatology.