The effect of testosterone and a nutritional supplement on hospital admissions in under-nourished, older people.
BACKGROUND
Weight loss and under-nutrition are relatively common in older people, and are associated with poor outcomes including increased rates of hospital admissions and death. In a pilot study of 49 undernourished older, community dwelling people we found that daily treatment for one year with a combination of testosterone tablets and a nutritional supplement produced a significant reduction in hospitalizations. We propose a larger, multicentre study to explore and hopefully confirm this exciting, potentially important finding (NHMRC project grant number 627178).


METHODS
One year randomized control trial where subjects are allocated to either oral testosterone undecanoate and high calorie oral nutritional supplement or placebo medication and low calorie oral nutritional supplementation. 200 older community-dwelling, undernourished people [Mini Nutritional Assessment score <24 and either: a) low body weight (body mass index, in kg/m(2): <22) or b) recent weight loss (>7.5% over 3 months)]. Hospital admissions, quality-adjusted life years, functional status, nutritional health, muscle strength, body composition and other variables will be assessed.


CONCLUSIONS
The pilot study showed that combined treatment with an oral testosterone and a supplement drink was well tolerated and safe, and reduced the number of people hospitalised and duration of hospital admissions in undernourished, community dwelling older people. This is an exciting finding, as it identifies a treatment which may be of substantial benefit to many older people in our community. We now propose to conduct a multi-centre study to test these findings in a substantially larger subject group, and to determine the cost effectiveness of this treatment.


BACKGROUND
Australian Clinical Trial Registry: ACTRN 12610000356066.
The Health Observatory, University of Adelaide, Department of Medicine, Adelaide SA 5005, Australia.
Cynthia
C
Piantadosi
Renuka
R
Visvanathan
Vasi
V
Naganathan
Peter
P
Hunter
Ian D
ID
Cameron
Kylie
K
Lange
Jonathan
J
Karnon
Ian M
IM
Chapman
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000178:diet therapy* / Q000188:drug therapy* / Q000453:epidemiology; D009752:Nutritional Status / Q000187:drug effects / Q000502:physiology; D010343:Patient Admission / Q000639:trends; D010865:Pilot Projects; D019057:Quality-Adjusted Life Years; D013739:Testosterone / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome
D013739:Testosterone; C010792:testosterone undecanoate