The beneficial effects of a six month-long testosterone treatment on muscle mass, strength and quality of life in frail elderly men, no longer exist at six months post-treatment, concluded a new study carried out by researchers at the University of Manchester, United Kingdom.
Older men develop a certain frailty, related to age and the physical limitation caused by the loss of muscle mass and function.
The problem is that this process causes the decline of the individual, starting with dependency, institutionalization and ultimately death.
Because testosterone levels decline in all men (more or less), testosterone replacement is the most common therapy.
Until now, short-term testosterone treatment in frail elderly men has had positive results in improving muscle mass and strength but whether these effects could be maintained after treatment was rather uncertain.
For the study, the researchers assessed 274 intermediate-frail and frail elderly men, aged between 65 and 90 years, which presented low levels of testosterone.
For a period of six months, participants were given either a testosterone gel, or a placebo, and they had their condition evaluated at baseline, at the end of the treatment and also six months after the treatment had ended.
The results showed that even if six months of testosterone treatment increased lean body mass, muscle strength and quality of life, these positive effects were not durable, six months after treatment.
Frederick Wu, MD, of the University of Manchester in the United Kingdom and lead author of the study, said that “since the use of testosterone in elderly men raises concerns regarding adverse effects on the prostate and cardiovascular system, it's important to determine if short-term treatment can lead to prolonged benefits beyond the duration of testosterone exposure.
“Our findings suggest it may not be possible to break or interrupt the cycle of decline in physical function in frailty by short-term anabolic pharmacological intervention using testosterone supplementation for six months.”
Wu said that it is yet unknown how long should a testosterone replacement treatment last, so that the positive effects could persist in time.
“To best interrupt the downward spiral into frailty a greater emphasis should be placed on a multi-disciplinary interventional approach including resistance exercise, diet and other lifestyle options, in conjunction with pharmacological agents,” he added.
The study was accepted for publication in
The Endocrine Society's Journal of Clinical Endocrinology & Metabolism (JCEM).
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