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Senior Citizen Health & Medicine
Low Testosterone after Age 40 Increases Death Risk
for Men by 88 Percent
Testosterone level declines
with age - about 1.5% yearly after 30
August 14, 2006 - Men who have a low testosterone
level after age 40 may have a higher risk of death over a four-year
period than those with normal levels of the hormone, according to a
report in the August 14/28 issue of the Archives of Internal Medicine,
one of the JAMA/Archives journals.
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Unlike women undergoing menopause, middle-aged men
generally do not experience a dramatic decrease in the production of sex
hormones, according to background information in the article.
Testosterone levels gradually decline as a man
ages, decreasing approximately 1.5 percent per year after age 30. The
effects of low testosterone levels include decreased muscle mass and
bone density, insulin resistance, decreased sex drive, less energy,
irritability and feelings of depression.
Molly M. Shores, M.D., and colleagues at the VA
Puget Sound Health Care System and University of Washington, Seattle,
studied the relationship between hormone levels and death in a total of
858 male veterans older than age 40 years.
All participants received care in the VA Puget
Sound Health Care System and had their testosterone levels checked at
least twice between 1994 and 1999, with at least one week and no more
than two years elapsing between tests. The men were followed for an
average of 4.3 years and a maximum of eight years, through 2002.
About 19 percent (166) of the men had a low
testosterone level; 28 percent (240) had an equivocal testosterone
level, meaning that their tests revealed an equal number of low and
normal levels; and 53 percent (452) had normal testosterone levels.
One-fifth (20.1 percent) of the men with normal
testosterone levels died during the course of the study, compared with
24.6 percent of men with equivocal levels and 34.9 percent of those with
low levels.
Men with low testosterone levels had an 88 percent
increase in risk of death compared with those who had normal levels.
When the researchers considered other variables
that may influence risk of death, such as age, other illnesses and body
mass index, the association between low testosterone levels and death
persisted.
Previous studies have found that testosterone
levels may dramatically decrease one to two days after surgery, trauma
or critical illness-all factors that can increase the risk of death. To
eliminate these effects, the authors reanalyzed the data excluding men
who had died within the first year of follow-up. Men with low
testosterone levels were still 68 percent more likely to have died.
"The persistence of elevated mortality risk after
excluding early deaths suggests that the association between low
testosterone and mortality is not simply due to acute illness," they
write. "Large prospective studies are needed to clarify the association
between low testosterone levels and mortality."
Editor's Note: This study was
supported by the Geriatric Research, Education and Clinical Center, VA
Puget Sound Health Care System; the Royalty Research Fund of the
University of Washington (Dr. Shores); and a VA merit review grant (Dr.
Matsumoto). Please see the article for additional information, including
other authors, author contributions and affiliations, financial
disclosures, funding and support, etc.
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