Is the Androgen Deficiency of Aging Men (ADAM) questionnaire useful for the screening of partial androgenic deficiency of aging men?
BACKGROUND
Androgen serum levels significantly decrease in older men, causing quality of life impairment and increasing the risk of chronic disease. This disorder is defined as PADAM (Partial Androgen Deficiency of Aging Men).


OBJECTIVE
To evaluate a PADAM screening tool and determine the prevalence of this disorder in healthy adult men.


METHODS
This was a cross-sectional study in which 96 men aged 40 or more of the South Metropolitan Region of Santiago de Chile were surveyed with the Androgen Deficiency of Aging Men (ADAM) questionnaire of the Saint Louis University and sampled for the serum determination of total testosterone, sexual hormone binding globulin (SHBG) and albumin. Also free and bioavailable testosterone were calculated. PADAM was considered present if items 1 or 7 or any 3 other questions of the ADAM questionnaire were positive. An available testosterone of <198.4 ng/dL was used as a gold standard for the diagnosis of PADAM.


RESULTS
A total of 78 men (81.3%) were identified as possible PADAM according to the ADAM questionnaire. Total testosterone levels fell from 503.6+/-180.1 ng/dL in men aged 40 to 54 years to 382.1+/-247.3 in those >70 years; however this was not statistically significant (ANOVA, p=0.06). In the same age groups, SHBG significantly increased (31.0+/-15.0 to 47.5+/-15.0 nmol/L, p<0.001) whereas free and available testosterone significantly decreased (10.6+/-3.2 to 6.4+/-3.6 ng/dL and 266.6+/-81.2 to 152.2+/-97.6 ng/dL, respectively, p<0.0001). Overall (n=96), available testosterone confirmed PADAM diagnosis in 27 cases (28.1%). The ADAM tool rendered a 83.3% sensitivity and 19.7% specificity in the detection of PADAM. Item 1 (decreased sexual desire) was a better predictor of hypogonadism than the complete questionnaire (63.3% sensitivity and 66.7% specificity).


CONCLUSIONS
In this series, in accordance to available testosterone, the prevalence of PADAM was determined to be high, in which the ADAM questionnaire rendered a low diagnostic efficiency. PADAM diagnosis could be clinically suspected when symptoms of sexual dysfunction are present.
Blümel
Juan E
JE
Facultad Medicina, Universidad de Chile, Santiago de Chile, Chile.
Chedraui
Peter
P
Gili
Sebastian A
SA
Navarro
Alejandra
A
Valenzuela
Karen
K
Vallejo
Soledad
S
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000728:Androgens / Q000172:deficiency*; D047649:Andropause / Q000502:physiology*; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012709:Serum Albumin / Q000378:metabolism; D012738:Sex Hormone-Binding Globulin / Q000378:metabolism; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood
D000728:Androgens; D012709:Serum Albumin; D012738:Sex Hormone-Binding Globulin; D013739:Testosterone