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Age-related decline in testosterone levels

SEATTLE, WASHINGTON. There is ample evidence that testosterone levels in men decline with age. It is estimated that about 20% of men in their 60s have low testosterone levels (total testosterone 3.0 ng/mL or less or free testosterone of 9.0 pg/mL or less). This figure rises to about 50% in men aged 80 years or older. Low testosterone levels can also be caused by excessive alcohol consumption, certain chronic medical conditions, and the use of drugs such as corticosteroids and opiates.

Researchers at the Veterans Affairs Puget Sound Health Care System recently completed a study to see if older men with low testosterone levels were more likely to have impaired physical functioning, greater incidence of depression, and a higher mortality. The study included 44 men (average age of 75 years) who were admitted to a geriatric evaluation and management unit over a 6-month period. Twenty-nine or 66% of the men were found to have low testosterone levels.

The researchers found a significant association between low testosterone levels and the ability to move about and also noted a trend towards increased 6-month mortality in low testosterone men. They observed no significant association between low testosterone levels and depression. After considering other important factors in mortality risk (age, BMI, serum albumin, diabetes, depression, prostate cancer, alcohol abuse, and overall illness severity) the researchers, using a Cox regression analysis, conclude that men with low testosterone levels have a 28 times greater risk of early death than do men with higher levels. They point out that the number of patients in their study was small and urge larger studies to confirm their findings and to determine if testosterone replacement will improve physical functioning, enhance quality of life, and decrease mortality rates in frail, elderly men.
Shores MM, et al. Low testosterone is associated with decreased function and increased mortality risk: a preliminary study of men in a geriatric rehabilitation unit. J Am Geriatr Soc. 2004 Dec;52(12):2077-81

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