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Re: The Relationship between Health-Related Quality of Life, Obesity and Testosterone Levels in Older Men
GERIATRICS
497
Re: The Relationship between Health-Related Quality of Life, Obesity and Testosterone Levels in Older Men D. Glintborg, T. L. Nielsen, K. Wraae, D. Hougaard, C. Gudex, K. Brixen and M. Andersen Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark Age Ageing 2014; 43: 280e284.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.05.048 available at http://jurology.com/ Editorial Comment: Overweight and obesity have reached epidemic proportions among adults in the United States and many other developed countries. Numerous chronic health problems have been linked to aging and obesity. Data from this population based cross-sectional study of 598 older men in Denmark showed that central obesity, as reflected by measurement of waist circumference, was negatively associated with multiple quality of life parameters as measured by the SF-36Ò Health Survey. Conversely higher levels of bioavailable testosterone were associated with better quality of life outcomes, although central obesity demonstrated a stronger overall influence. It would be interesting to see if therapeutic interventions such as diet, exercise, weight loss and hormonal replacement therapy might influence these outcomes. This study did not specifically examine hypogonadal men, and they may have substantially different outcomes compared to a more general older male population. Tomas L. Griebling, MD, MPH
Suggested Reading Kaplan SA, Meehan AG and Shah A: The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. What are the implications for the relatively high incidence of erectile dysfunction observed in these men? J Urol 2006; 176: 1524.
Re: Low Testosterone Levels, Depressive Symptoms, and Falls in Older Men: A Cross-Sectional Study N. Kurita, S. Horie, S. Yamazaki, K. Otoshi, K. Otani, M. Sekiguchi, Y. Onishi, M. Takegami, R. Ono, S. Konno, S. Kikuchi and S. Fukuhara Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, and Institute for Health Outcomes and Process Evaluation Research (i-Hope International), Kyoto, Departments of Urology, Juntendo University School of Medicine and Teikyo University School of Medicine, Tokyo, Department of Orthopedic Surgery, School of Medicine and Center for Innovative Research in Clinical Evaluative Science (CiRCLE), Fukushima Medical University, Fukushima, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka and Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan J Am Med Dir Assoc 2014; 15: 30e35.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.05.049 available at http://jurology.com/ Editorial Comment: Falls are a common and often dangerous occurrence among elderly individuals. As a geriatric syndrome, a wide variety of clinical factors can increase the propensity for falls among older adults. Impairments in mobility and cognition, decreased functional status, frailty and urinary incontinence have all been identified as potential risk factors. In this cross-sectional study of 482 elderly men in Japan decreased testosterone levels and depressive symptoms were associated with an increased risk of falls. Overall prevalence of falls was 10.8% but the rate of injurious falls was not reported. The relationships between low testosterone and depression and the rate of falls appeared to be multiplicative, with the combination of these variables having stronger predictive power than either low testosterone or depression alone. Although not specifically examined in this research study, hypogonadal elderly men may be at particularly increased risk for hip and long bone fractures from falls due to associated osteopenia or osteoporosis. Testosterone levels and depression
497
Re: The Relationship between Health-Related Quality of Life, Obesity and Testosterone Levels in Older Men D. Glintborg, T. L. Nielsen, K. Wraae, D. Hougaard, C. Gudex, K. Brixen and M. Andersen Endocrinology and Metabolism, Odense University Hospital, Odense, Denmark Age Ageing 2014; 43: 280e284.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.05.048 available at http://jurology.com/ Editorial Comment: Overweight and obesity have reached epidemic proportions among adults in the United States and many other developed countries. Numerous chronic health problems have been linked to aging and obesity. Data from this population based cross-sectional study of 598 older men in Denmark showed that central obesity, as reflected by measurement of waist circumference, was negatively associated with multiple quality of life parameters as measured by the SF-36Ò Health Survey. Conversely higher levels of bioavailable testosterone were associated with better quality of life outcomes, although central obesity demonstrated a stronger overall influence. It would be interesting to see if therapeutic interventions such as diet, exercise, weight loss and hormonal replacement therapy might influence these outcomes. This study did not specifically examine hypogonadal men, and they may have substantially different outcomes compared to a more general older male population. Tomas L. Griebling, MD, MPH
Suggested Reading Kaplan SA, Meehan AG and Shah A: The age related decrease in testosterone is significantly exacerbated in obese men with the metabolic syndrome. What are the implications for the relatively high incidence of erectile dysfunction observed in these men? J Urol 2006; 176: 1524.
Re: Low Testosterone Levels, Depressive Symptoms, and Falls in Older Men: A Cross-Sectional Study N. Kurita, S. Horie, S. Yamazaki, K. Otoshi, K. Otani, M. Sekiguchi, Y. Onishi, M. Takegami, R. Ono, S. Konno, S. Kikuchi and S. Fukuhara Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, and Institute for Health Outcomes and Process Evaluation Research (i-Hope International), Kyoto, Departments of Urology, Juntendo University School of Medicine and Teikyo University School of Medicine, Tokyo, Department of Orthopedic Surgery, School of Medicine and Center for Innovative Research in Clinical Evaluative Science (CiRCLE), Fukushima Medical University, Fukushima, Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka and Department of Community Health Sciences, Kobe University Graduate School of Health Sciences, Kobe, Japan J Am Med Dir Assoc 2014; 15: 30e35.
Abstract for this article http://dx.doi.org/10.1016/j.juro.2015.05.049 available at http://jurology.com/ Editorial Comment: Falls are a common and often dangerous occurrence among elderly individuals. As a geriatric syndrome, a wide variety of clinical factors can increase the propensity for falls among older adults. Impairments in mobility and cognition, decreased functional status, frailty and urinary incontinence have all been identified as potential risk factors. In this cross-sectional study of 482 elderly men in Japan decreased testosterone levels and depressive symptoms were associated with an increased risk of falls. Overall prevalence of falls was 10.8% but the rate of injurious falls was not reported. The relationships between low testosterone and depression and the rate of falls appeared to be multiplicative, with the combination of these variables having stronger predictive power than either low testosterone or depression alone. Although not specifically examined in this research study, hypogonadal elderly men may be at particularly increased risk for hip and long bone fractures from falls due to associated osteopenia or osteoporosis. Testosterone levels and depression