title: Effects of testosterone on muscle strength, physical function, body composition, and quality of life in intermediate-frail and frail elderly men: a randomized, double-blind, placebo-controlled study.
abstract: BACKGROUND
  Physical frailty is associated with reduced muscle strength, impaired physical function, and quality of life. Testosterone (T) increases muscle mass and strength in hypogonadal patients. It is unclear whether T has similar effects in intermediate-frail and frail elderly men with low to borderline-low T.
  
  
  OBJECTIVE
  Our objective was to determine the effects of 6 months T treatment in intermediate-frail and frail elderly men, on muscle mass and strength, physical function, and quality of life.
  
  
  METHODS
  We conducted a randomized, double-blind, placebo-controlled, parallel-group, single-center study.
  
  
  METHODS
  PARTICIPANTS were community-dwelling intermediate-frail and frail elderly men at least 65 yr of age with a total T at or below 12 nmol/liter or free T at or below 250 pmol/liter.
  
  
  METHODS
  Two hundred seventy-four participants were randomized to transdermal T (50 mg/d) or placebo gel for 6 months. Outcome measures included muscle strength, lean and fat mass, physical function, and self-reported quality of life.
  
  
  RESULTS
  Isometric knee extension peak torque improved in the T group (vs. placebo at 6 months), adjusted difference was 8.6 (95% confidence interval, 1.3-16.0; P = 0.02) Newton-meters. Lean body mass increased and fat mass decreased significantly in the T group by 1.08 +/- 1.8 and 0.9 +/- 1.6 kg, respectively. Physical function improved among older and frailer men. Somatic and sexual symptom scores decreased with T treatment; adjusted difference was -1.2 (-2.4 to -0.04) and -1.3 (-2.5 to -0.2), respectively.
  
  
  CONCLUSIONS
  T treatment in intermediate-frail and frail elderly men with low to borderline-low T for 6 months may prevent age-associated loss of lower limb muscle strength and improve body composition, quality of life, and physical function. Further investigations are warranted to extend these results.
authors.affiliation: Andrology Research Unit, Department of Medicine and Endocrinology, University of Manchester, Manchester Royal Infirmary, Grafton Street, Manchester, United Kingdom M13 9WL.
authors.forename: Upendram
authors.initials: U
authors.lastname: Srinivas-Shankar
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Roberts
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Connolly
authors.forename: Matthew D L
authors.initials: MD
authors.lastname: O'Connell
authors.forename: Judith E
authors.initials: JE
authors.lastname: Adams
authors.forename: Jackie A
authors.initials: JA
authors.lastname: Oldham
authors.forename: Frederick C W
authors.initials: FC
authors.lastname: Wu
mesh_terms: D000368:Aged; D001823:Body Composition / Q000187:drug effects*; D004311:Double-Blind Method; D016330:Frail Elderly; D005684:Gait / Q000187:drug effects; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000187:drug effects*; D053580:Muscle Strength / Q000187:drug effects*; D004856:Postural Balance / Q000187:drug effects; D011788:Quality of Life; D013739:Testosterone / Q000009:adverse effects / Q000097:blood / Q000494:pharmacology*
chemical_list: D013739:Testosterone