Endocrine Abstracts

Testosterone treatment improves muscle strength, lean mass and quality of life in prefrail and frail elderly men: results from a randomised double-blind placebo-controlled study

Upendram Srinivas-Shankar¹, Stephen A Roberts², Judith E Adams³, Martin J Connolly⁴, Jackie A Oldham⁵ & Frederick CW Wu¹

¹Department of Endocrinology, Manchester Royal Infirmary, Manchester, UK; ²Biostatistics Group, University of Manchester, Manchester, UK; ³Clinical Radiology, University of Manchester, Manchester, UK; ⁴Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand; ⁵Department of Rehabilitation Science, University of Manchester, Manchester, UK.

Introduction: Testosterone (T) improves muscle strength in hypogondal men. It is unclear if testosterone has similar effects in prefrail and frail elderly men with low T. We conducted a randomised double-blind placebo-controlled parallel group study to determine the effects of T on muscle mass and strength, physical function and quality of life in prefrail and frail elderly men.

Methods: Two hundred and sixty two prefrail and frail elderly men (Fried et al. 2001), mean age (range) 74 (65–89) years received testosterone (25–75 mg/d) or placebo gel for 6 months. Outcome measures included muscle strength ((primary end points – isometric peak torque, knee extension (EIMPT) and flexion (FIMPT)), physical function tests, lean mass (DXA) and quality of life (aging males’ symptom (AMS) scale). Ethical approval was obtained from the Central Manchester research ethics committee.

Results: T at baseline was 10.9±3.1 and 11±3.2 mean (SD) nmol/l in active and placebo groups. T increased to 22.9±10 nmol/l in the active with no change in placebo group (11.3±5.2 nmol/l). EIMPT improved by 6% (P=0.042) in active and 3% (P=0.17) in placebo group. Men who reached target testosterone levels during treatment achieved higher EIMPT (10% increment) versus those that did not (2%). Physical function tests improved but did not reach statistical significance. Somatic subscale domain of AMS scale improved; adjusted difference (95%CI) for active vs. placebo group was −1.2 (−2.4 to −0.04). Lean mass increased (1.07 kg, P<0.0001) in the active vs. placebo group.

Conclusions: Treatment with transdermal testosterone for 6 months, leads to improvement in muscle strength, lean mass and somatic subscale domain (AMS scale) in prefrail and frail elderly men.

Endocrine Abstracts (2008) 15 OC7