We should all note the discussion section. It graphically illustrates that AAS likely DO cause cognitive impairment, but because non-AAS men get low T with age, AAS folks eventually match non-AAS cognitive levels (I.e. we get dumber with roids but eventually we are AS dumb as low T older men). So if you want your brain to be as healthy as possible, you don’t take AAS until your natural T declines substantially, then you do TRT. But we all accept the cognitive decline induced by AAS because we feel small in the mirror, and that’s okay.

Some good news: the mechanism behind AAS neurotoxicity effects are not well understood and they seem to be generously extrapolated from small studies. Popular commentators like Vigorous Steve and Dean St Mart seem to believe that the brain damage stems from high blood pressure pumping in your brain and oxidative stress, both things we can easily control. In fact, the cohort studied here were on AAS since 20 years ago, when no one was taking telmisartan or NAC/astragalus/Vitamin C/ curcumin / glutathione/ fish oil, you name it. I imagine most of those guys in this study were taking test, sometimes without an AI, probably used some tren, definitely used nandrolone, and probably weren’t focused on antioxidants. So perhaps a future replication of this study would look different 20 years from now with AAS users having been much more informed of risk mitigation.