Testosterone and frailty in elderly men

With aging, there is an increase of the incidence of frailty. Frailty is associated with adverse health outcomes, like falls and fractures, disabilities, hospitalization, institutionalization and mortality. It is generally accepted that frailty, unlike the aging process, is in part reversible and amenable to interventions. Two physical changes appear to be the main cause of frailty, namely loss of muscle mass (sarcopenia) and bone mineral density. The last decades more attention has been raised to the potential importance of androgens in etiology, prevention of treatment of frailty. In this thesis, we investigated the relation between androgens, sarcopenia, bone mineral density and frailty in men and we assessed the effects of testosteron supplementation on these parameters. For the first research question, we found that testosterone was indirectly associated with sarcopeniq and bone mineral density. Low testosterone levels leads to inflammation, disturbances of the glucose metabolism and changes of body composition, which results to sarcopenia and low bone mineral density, and finally to frailty. For the second research question, we found that testosterone supplementation during 6 months to elderly men with low-normal testosterone levels had a positive effect on body composition (increase of lean body mass, decrease of fat mass), glucose metabolism and hormone-related quality of life. There were no beneficial effects on muscle strength and functional mobility, cognitive function, bone mineral density and sexual functioning. Testosterone supplementation was safe and well tolerated.