Endocrine Abstracts

Introduction: Testosterone (T) improves muscle strength in hypogondal patients. It is unclear if testosterone has similar effects in 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 frail elderly men from the general population.

Methods: Two hundred and sixty-two prefrail and frail elderly men (criteria of 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 (S.D.) 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 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 versus placebo group.

Conclusions: Treatment with transdermal testosterone for 6 months, leads to improvement in lean mass, muscle strength and physical symptom – related quality of life in prefrail and frail elderly men.