MedWire News: Elderly, frail men may benefit from testosterone therapy, say US researchers who found that the treatment modestly improved bone mineral density (BMD).
Testosterone deficiency is thought to contribute to age-related bone loss, muscle weakness, and frailty, but most studies of testosterone supplements have been performed in relatively healthy older men, explain Anne Kenny (University of Connecticut Health Center, Farmington) and co-authors.
To determine the impact of testosterone supplements in the frail, the team recruited 131 men, aged an average of 77.1 years who were known to have low levels of the hormone (<350 ng/dl), a history of fracture, or a BMD T-score of less than –2.0 at the hip, and met at least one of the criteria for frailty, such as weight loss or walking speed.
The men were randomly assigned to receive testosterone 5 mg/day or placebo for 12–24 months, as well as calcium 1500 mg/day and cholecalciferol 1000 IU/day.
The men completed an average of 23 months of treatment, with 75.6% completing 12 months and 47.3% completing 24 months of the study. Up to 56% of the men adhered to the treatment protocol, with 40% of the men adhering at least 70% of the time.
At 12 months, testosterone and bioavailable testosterone levels were significantly higher in the treatment group versus controls, at 583 ng/dl and 157 ng/dl versus 407.8 ng/dl and 66.1 ng/dl, respectively.
Men given testosterone achieved a significant 1.4% BMD increase at the femoral neck and 3.2% increase in the lumbar spine, but no such increase occurred in the controls. BMD fell significantly by 1.3% at the mid radius of the testosterone-treated men but did not change in the controls.
Testosterone was also associated with an increase in lean mass and a decrease in fat mass, but was not significantly linked to changes in the patients’ strength or physical performance.
There were no significant differences in reports for prostate symptoms, cardiovascular disease, or cholesterol levels between the treatment groups.
The researchers conclude: “Further study of testosterone therapy in older, frail men will be required to more-completely understand the risks and benefits of testosterone supplementation in this population.”
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