Quality of life in elderly men with androgen deficiency

Abstract

The partial androgen deficiency in aging male (PADAM) has been of great interest to investigators and the public in the last few years. For males, androgens are said to be essential for the maintenance of quality of life (QoL) but there are no data available with respect to QoL and PADAM yet. In order to evaluate changes of individual well-being of males older than 50 years and with subnormal levels of free testosterone (FT) (<200 pmol l(-1)), these men were asked to fill in a questionnaire regarding QoL. The objective of this study was to compare age-matched males with androgen deficiency (group 1; n = 24) and normoandrogenic elderly men (group 2; n = 24) with respect to QoL and somatic indicators of the endocrine status. Participants suffered from benign prostatic hyperplasia (BPH) and were hospitalized for prostate surgery. Health-related QoL was assessed by the SF-12 Health Survey, including the physical health index and the mental health index. The SF-12 was enlarged by the scales 'vitality' and 'psychological well-being' of the SF-36. Additionally, patients were asked about social and clinical items. There were no statistically significant differences between the two groups regarding social and clinical parameters. The physical health index was reduced in group 1 (P < 0.05; effect size was medium (d = 0.57)) whereas the mental health index was similar in both groups. The correlation between the two health indices was very low and not statistically significant (r = 0.05, P = 0.72). Patients of group 1 described a lower vitality compared to group 2 (P < 0.05), but no differences could be observed regarding psychological well-being. Therefore, androgen-deficient patients seem to have the impression of a reduced physical ability. Our data emphasize that the subjective description of health-related aspects of QoL is a very sensitive methodological approach to discover psychological differences between patients. For the differentiation between androgen-deficient patients and those with normal testosterone levels the physical health index seems to be more sensitive than the mental health index. A question of interest is whether this difference remains detectable if testosterone is supplemented to androgen-deficient men. Whether testosterone supplementation is beneficial to these patients has to be carefully considered.

Assessing Function and Endurance in Adults with Spinal and Bulbar Muscular Atrophy: Validity of the Adult Myopathy Assessment Tool

“…The SF-36v2 is a 36-item, 4-week recall health-related quality of life assessment that has been used in multiple disorders and can be condensed into 2 summary measures: the physical component summary (PCS) and the mental component summary (MCS) [36, 37]. Using the SAS code provided by QualityMetric Inc., raw scores were converted into normative-based scores with a mean score of 50 (standard deviation, ±10).…”

Clinical features of spinal and bulbar muscular atrophy

“…The subjects also completed the Medical Outcomes Study 36-item Short Form Version 2 questionnaire (SF-36v2), a 4 week-recall quality of life assessment that has been widely used previously (Riazi et al , 2003; Finas et al , 2006). Using the statistical analysis system analysis code provided by QualityMetric, Inc. (Lincoln, RI), raw scores were converted into norm-based scores with a mean of 50 and a standard deviation (SD) of 10 (Ware et al , 2007).…”

Are declining testosterone levels a major risk factor for ill-health in aging men?

“…For example, in one study men older than 50 years with free testosterone levels o200 pmol l À1 had poorer quality of life as assessed by the Short-Form SF-12 Health Survey questionnaire, particularly the physical health index. 48 However, another study of men 55 years or older did not find a correlation between bioavailable testosterone and various health outcomes including sexual and quality of life assessments. 49 In the setting of androgen deprivation therapy in men with prostate cancer, men receiving treatment that drastically reduced circulating total and free testosterone levels reported impotence, reduced vitality and reduced overall quality of life.…”