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Title: Study of the effects of testosterone on body composition, muscle strength, physical function and quality of life in frail elderly men
Author: Srinivas-Shankar, Upendram
ISNI:       0000 0004 2671 3682
Awarding Body: The University of Manchester
Current Institution: University of Manchester
Date of Award: 2009
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In this double-blind, placebo-controlled study, 274 frail elderly men, mean age, 74 years with total testosterone (T)≤12 nmol/L or free T≤250 pmol/L were randomized to transdermal T (50 mg/d) or placebo gel for 6 months. Outcome measures, included muscle strength (dynamometry), lean and fat mass (dual energy x ray absorptiometry), physical function and quality of life (Aging Males' Symptom rating scale, AMS and Short Form 36, SF 36). Testosterone concentrations at baseline were 11.0±3.2 and 10.9±3.1 nmol/L (mean±SD) in the active and placebo groups respectively. Testosterone concentrations increased to 22.9±10 and 18.4±9.2 nmol/L in the T-treated group at 3 and 6 months respectively, while remaining unchanged in the placebo group. Isometric knee extension peak torque in the T group by, mean (SD) 4.7 (31.0) Newton meters (Nm) and decreased in the placebo group by 4.7 (25.5) Nm. The adjusted difference between the groups was significant (P=0.02). The other muscle strength endpoints (isometric knee flexion and isokinetic knee extension and knee flexion peak torques) improved in both the groups, but the adjusted difference between the groups was not significant. Lean body mass increased and fat mass decreased significantly in the T group by 1.08±1.8 and 0.9±1.6 kg respectively. Physical function tests improved in the older (≥75 years) and frailer (≥2 frailty criteria) in men, not in the entire cohort. Somatic and sexual symptoms (AMS) and physical summary score (SF 36) improved in the testosterone group compared to placebo. There was no increase in prostate-related adverse events in the testosterone group compared to placebo. It is concluded that short-term testosterone treatment of frail elderly men with low to borderline-low testosterone levels may preserve age-associated loss of muscle strength. In addition, treatment improved body composition and quality of life. Physical function improved among older and frailer men. These encouraging results need to be replicated in studies of a longer duration.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available