ABSTRACT
Considerable public interest and scientific effort has been directed towards the study of the aging male, with particular attention being focused on whether androgens can assist in the maintenance of lean body mass and strength with age. It is well established that with advancing age men undergo a gradual but inevitable decline in gonadal function, often resulting in undiagnosed hypogonadism. A few of the associated symptoms of age-related male hypogonadism or andropause are loss of lean body mass, increased adiposity, and decline in muscle strength and function. It is therefore not surprising that agerelated sarcopenia poses a major health concern in old age and is identified worldwide as a significant public-health problem.1,2
Of primary concern is the progressive reduction in lean muscle mass and strength that occurs with aging. While the mechanisms for the decline are only just beginning to be explained,3 the resulting loss of contractile tissue and functional capacity contributes to the increase prevalence of lowerextremity weakness and bone resorption, thus increasing fall-related disability (i.e. bone fracture) in the aging male.4,5 Indeed, the ability to counteract progressive losses in skeletal muscle mass and strength in older men has considerable implications. By attenuating or even preventing these losses, older individuals will have an improved quality of life, prolonged independent living, and a
significantly reduced dependence on structured health-care. Apart from the obvious pitfalls of agerelated sarcopenia, there are also metabolic consequences to be considered. These may include a depressed basal metabolic rate, hypothalamic disruption of thermoregulation, glucose intolerance, altered lipid metabolism, and enhanced osteoporosis. Thus, as the population of older men grows the need to develop therapies to counteract losses in skeletal muscle mass and strength associated with aging takes on added significance.
