Testosterone Improves Rehabilitation Outcomes in Ill Older Men

Bakhshi, Virat; Elliott, Marjorie; Gentili, Angela; Godschalk, Michael; Mulligan, Thomas

doi:10.1111/j.1532-5415.2000.tb05002.x

Cited by 108 publications

(67 citation statements)

References 29 publications

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“…5 Yet, it has not only been difficult to correlate hormone levels with these age-related phenomena, 3,4 but testosterone replacement in elderly men is not especially effective in reversing these symptoms. 6,7 For example, although testosterone replacement in elderly men has been demonstrated to enhance upper limb strength 8,9 and mass, 7 improve bone mineral density, 6 increase hematocrit, 10 and reduce leptin levels (an effect that may improve visceral adiposity), 8 such effects are apparently weak and likely of no clinical consequence. There are few testosterone replacement studies in which psychiatric symptoms of age-related hypogonadism have been considered.…”

Section: Introductionmentioning

confidence: 99%

Normative hypogonadism and depression: does ‘andropause’ exist?

Seidman

2006

Int J Impot Res

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The progressive decline in testosterone level has been demonstrated in both cross-sectional and longitudinal studies, and overall at least 25% of men over the age of 70 years meet laboratory criteria for hypogonadism (i.e., testosterone deficiency). Such age-associated HPG hypofunctioning, which has been termed 'andropause', is thought to be responsible for a variety of symptoms experienced by elderly men, including sexual dysfunction and depression. Although, it has been difficult to establish correlations between 'andropausal' symptoms and plasma testosterone levels, there is some evidence that testosterone replacement leads to improvement in muscle strength, bone mineral density, and erectile dysfunction. There is little evidence of a link between HPG-axis dysfunction and depressive illness, and exogenous androgens have not been consistently shown to be antidepressant. This article reviews the relationship between androgens and depression in aging men.

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Section: Introductionmentioning

confidence: 99%

Normative hypogonadism and depression: does ‘andropause’ exist?

Seidman

2006

Int J Impot Res

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“…7 Recently, T was shown to improve rehabilitation outcomes in older men with low-normal serum T levels during an 8-week inpatient rehabilitation stay. 8 Muscle strength and protein synthesis occur shortly after administration of exogenous T, 9 and relatively low dosages of T result in improved strength after 1 month in older men. 10 In young men, supraphysiological dosing of T enanthate results in dramatic exercise-independent increases in strength, muscle size and fat-free body mass without adverse affects on lipids, prostate-specific antigen (PSA), mood or behavior.…”

mentioning

confidence: 99%

Preoperative Supraphysiological Testosterone in Older Men Undergoing Knee Replacement Surgery

Amory¹,

Chansky

et al. 2002

J American Geriatrics Society

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OBJECTIVES:Older patients undergoing knee replacement surgery can recover more slowly than younger patients and require extended rehabilitation. Because administration of supraphysiological testosterone (T) dramatically increases strength, we hypothesized that preoperative T therapy would improve functional recovery and reduce hospital stay in older men undergoing knee replacement surgery. DESIGN: Double-blinded, placebo-controlled pilot trial. SETTING: A Veterans Affairs orthopedics clinic and inpatient postoperative unit. PARTICIPANTS: Twenty-five men, mean age 70, undergoing elective knee replacement. INTERVENTION: Preoperative, supraphysiological T administration (600 mg T enanthate intramuscularly weekly for 4 weeks) or sesame oil placebo. MEASUREMENTS: Length of hospital stay and functional ability by Functional Independence Measure (FIM) score. RESULTS: Mean length of hospital stay Ϯ standard deviation was nonsignificantly reduced in the T group (5.9 Ϯ 2.4 days vs 6.8 Ϯ 2.5 days; P ϭ .15). At postoperative Day 3, there was a significant improvement in ability to stand (mean FIM score 5.2 Ϯ 1.0 vs 4.0 Ϯ 1.1; P ϭ .04) and trends towards improvements in walking and stair climbing in the T group. There were no complications attributable to T therapy. CONCLUSIONS: In older men undergoing knee replacement surgery, preoperative supraphysiological T administration may confer some clinical benefit. Future studies using longer courses of preoperative T administration in larger numbers of older men undergoing knee replacement surgery are warranted. J Am Geriatr Soc 50:1698-1701, 2002. Key words: arthritis; arthroplasty; FIM; rehabilitation K nee replacement surgery is associated with beneficial outcomes in appropriately selected patients. More than 100,000 knee replacements are performed yearly in the United States, 1 and 90% of these patients are aged 55 and older. 2,3 Older patients have slower recovery of ambulatory function and strength in knee extensors than younger patients 4,5 and are more likely to require prolonged hospitalization or inpatient rehabilitation postoperatively. 4 Levels of testosterone (T) fall as men age, 6 and supplementation with T can improve strength in older hypogonadal men. 7 Recently, T was shown to improve rehabilitation outcomes in older men with low-normal serum T levels during an 8-week inpatient rehabilitation stay. 8 Muscle strength and protein synthesis occur shortly after administration of exogenous T, 9 and relatively low dosages of T result in improved strength after 1 month in older men. 10 In young men, supraphysiological dosing of T enanthate results in dramatic exercise-independent increases in strength, muscle size and fat-free body mass without adverse affects on lipids, prostate-specific antigen (PSA), mood or behavior. 11,12 Because strength plays such a pivotal role in recovery from a joint replacement operation, we hypothesized that short-term supraphysiological T therapy might improve postoperative outcomes in older men undergoing knee replacement surgery. Therefor...

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“…This may have important implications for the rehabilitation of brain injured patients with visual deficits. Testosterone may also have beneficial effects on muscle strength [6] and hence mobility in brain injured populations, although these domains were not assessed in the current study. Future studies will be necessary to clarify the mechanism of action of testosterone in brain injured individuals and also to determine if our current PET scan techniques are sensitive enough to measure metabolic changes that are induced by testosterone.…”

Section: Discussionmentioning

confidence: 71%

Case Report of the PET Scan Changes and Clinical Effects of Testosterone in the Treatment of a Stroke Patient

Tan¹

2012

TOANDROJ

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Abstract:Testosterone has been known to improve functionality in stroke patients. In this case, we sought to illustrate the possible cognitive effects of testosterone replacement therapy with the aid of PET scanning. Glucose metabolism generally worsened in this patient after 12 weeks of treatment. However, there was improved glucose metabolism (CGM) in the occipital lobe, middle temporal gyrus and cerebellum. The middle temporal gyrus is the location of the hippocampus, which is part of the limbic system and plays important roles in long term memory and spatial navigation. The patient reported that he was sharper after testosterone, and clinical testing showed modest improvements in performance. This case finding needs to be confirmed with larger randomized controlled studies; but affords a window to the possibility of adding testosterone for the rehabilitation of stroke patients.

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Testosterone Improves Rehabilitation Outcomes in Ill Older Men

Abstract: Testosterone supplementation may improve rehabilitation outcomes in ill older men.

Cited by 108 publications

References 29 publications

Normative hypogonadism and depression: does ‘andropause’ exist?

Normative hypogonadism and depression: does ‘andropause’ exist?

Preoperative Supraphysiological Testosterone in Older Men Undergoing Knee Replacement Surgery

Case Report of the PET Scan Changes and Clinical Effects of Testosterone in the Treatment of a Stroke Patient

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