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Clinical Section / Viewpoint

Editor's Choice - Free Access

Testosterone Deficiency and Testosterone Treatment in Older Men

Saad F.a, b · Röhrig G.c, d · von Haehling S.e · Traish A.f, g

Author affiliations

aGlobal Medical Affairs Andrology, Bayer AG, Berlin, Germany; bGulf Medical University, Ajman, United Arab Emirates; cAgeing Clinical Research, Department II Internal Medicine, University Hospital Cologne, and dClinic for Geriatrics at St. Marien-Hospital, Cologne, and eDepartment of Cardiology and Pneumology, University of Göttingen Medical School, Göttingen, Germany; Departments of fBiochemistry and gUrology, Boston University School of Medicine, Boston, MA, USA

Corresponding Author

Farid Saad

Global Medical Affairs Andrology, Bayer AG

Muellerstr. 178

DE-13353 Berlin (Germany)

E-Mail farid.saad@bayer.com

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Gerontology 2017;63:144-156

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Frailty is a clinical condition related to changes in metabolism, to sarcopenia, and to decline in muscle mass and strength, bone mineral density, and physical function with aging. The pathophysiology of frailty is multifactorial and associated with comorbidities. Testosterone is implicated in regulating metabolic functions, maintenance of muscle and bone, and inhibition of adipogenesis. In older individuals, reduced testosterone is thought to contribute to an altered state of metabolism, loss of muscle and bone, and increased fat, leading to sarcopenia, sarcopenic obesity, and frailty. While no direct relationship between testosterone deficiency (commonly known as hypogonadism) and frailty has been established (due to the multifactorial nature of frailty), clinical evidence suggests that testosterone deficiency is associated with increased sarcopenia and obesity. Testosterone treatment in frail older men with limited mobility and with testosterone deficiency improved insulin resistance, glucose metabolism, and body composition. These changes contribute to better physical function and improved quality of life. Because frailty increases disability, comorbidities, and the risk of hospitalization, institutionalization, and mortality in older men, it is warranted to explore the potential usefulness of testosterone treatment in frail men with hypogonadism in order to attenuate the progression of sarcopenia and frailty. In this paper, we will discuss the impact of testosterone deficiency on frailty and the potential role of testosterone treatment in ameliorating and reducing the progression of frailty. Such an approach may reduce disability and the risk of hospitalization and increase functional independence and quality of life.

© 2016 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Clinical Section / Viewpoint

Received: August 23, 2016
Accepted: October 15, 2016
Published online: November 18, 2016
Issue release date: February 2017

Number of Print Pages: 13
Number of Figures: 5
Number of Tables: 1

ISSN: 0304-324X (Print)
eISSN: 1423-0003 (Online)

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