Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men: a randomized controlled trial
- PMID: 18167405
- DOI: 10.1001/jama.2007.51
Effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men: a randomized controlled trial
Erratum in
- JAMA. 2008 Feb 13;299(6):634
Abstract
Context: Serum testosterone levels decline significantly with aging. Testosterone supplementation to older men might beneficially affect the aging processes.
Objective: To investigate the effect of testosterone supplementation on functional mobility, cognitive function, bone mineral density, body composition, plasma lipids, quality of life, and safety parameters in older men with low normal testosterone levels.
Design, setting, and participants: Double-blind, randomized, placebo-controlled trial of 237 healthy men between the ages of 60 and 80 years with a testosterone level lower than 13.7 nmol/L conducted from January 2004 to April 2005 at a university medical center in the Netherlands.
Intervention: Participants were randomly assigned to receive 80 mg of testosterone undecenoate or a matching placebo twice daily for 6 months.
Main outcome measures: Functional mobility (Stanford Health Assessment Questionnaire, timed get up and go test, isometric handgrip strength, isometric leg extensor strength), cognitive function (8 different cognitive instruments), bone mineral density of the hip and lumbar spine (dual-energy x-ray absorptiometry scanning), body composition (total body dual-energy x-ray absorptiometry and abdominal ultrasound of fat mass), metabolic risk factors (fasting plasma lipids, glucose, and insulin), quality of life (Short-Form Health 36 Survey and the Questions on Life Satisfaction Modules), and safety parameters (serum prostate-specific antigen level, ultrasonographic prostate volume, International Prostate Symptom score, serum levels of creatinine, aspartate aminotransferase, alanine aminotransferase, gamma-glutamyltransferase, hemoglobin, and hematocrit).
Results: A total of 207 men completed the study. During the study, lean body mass increased and fat mass decreased in the testosterone group compared with the placebo group but these factors were not accompanied by an increase of functional mobility or muscle strength. Cognitive function and bone mineral density did not change. Insulin sensitivity improved but high-density lipoprotein cholesterol decreased; by the end of the study, 47.8% in the testosterone group vs 35.5% in the placebo group had the metabolic syndrome (P = .07). Quality-of-life measures were no different except for one hormone-related quality-of-life measure that improved. No negative effects on prostate safety were detected.
Conclusion: Testosterone supplementation during 6 months to older men with a low normal testosterone concentration did not affect functional status or cognition but increased lean body mass and had mixed metabolic effects.
Trial registration: isrctn.org Identifier: ISRCTN23688581.
Comment in
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Effects of testosterone therapy in older men.JAMA. 2008 Apr 23;299(16):1900; author reply 1900-1. doi: 10.1001/jama.299.16.1900-a. JAMA. 2008. PMID: 18430907 No abstract available.
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Re: effect of testosterone supplementation on functional mobility, cognition, and other parameters in older men: a randomized controlled trial.Eur Urol. 2008 May;53(5):1084. doi: 10.1016/j.eururo.2008.02.008. Eur Urol. 2008. PMID: 18485319 No abstract available.
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Testosterone supplementation did not prevent cognitive decline or increase bone mineral density in older men.ACP J Club. 2008 May 20;148(3):4. ACP J Club. 2008. PMID: 18489067 No abstract available.
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Does testosterone supplementation improve health and function in elderly men?Nat Clin Pract Endocrinol Metab. 2008 Jul;4(7):374-5. doi: 10.1038/ncpendmet0840. Epub 2008 May 20. Nat Clin Pract Endocrinol Metab. 2008. PMID: 18493229 Free PMC article.
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Testosterone supplementation did not prevent cognitive decline or increase bone mineral density in older men.Evid Based Med. 2008 Jun;13(3):71. doi: 10.1136/ebm.13.3.71. Evid Based Med. 2008. PMID: 18515618 No abstract available.
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