Hormone treatment and muscle anabolism during aging: androgens

Aging is associated with a gradual decline in circulating testosterone concentrations and decreased musculature in men. While testosterone administration is often considered when symptoms of hypogonadism are presented, the long-term effects of androgen use on muscle physiology are not yet fully understood. The definition of hypogonadism in men remains obscure but is generally indicated by total testosterone concentrations less than a threshold value of 300-500 ng/dL. Androgen replacement therapy is generally safe in men and women with low endogenous testosterone concentrations. The development of selective androgen receptor modulators (SARMs) may provide additional options in treatment of hypogonadism while lowering the potential of side effects often associated with long-term androgen use. Androgen administration, either alone or in combination with other treatments, can be successful in improving muscle mass by increasing protein anabolism and reducing protein catabolism in men and women. Further research is necessary to optimize the anabolic and anticatabolic properties of androgens for treatment and prevention of muscle loss in men and women.

[Structured review of activities of daily living measures in older people]

OBJECTIVE

the present article evaluates the evidence relating to the conceptual adaptation, applicability and psychometric properties of activities of daily living measures in Spanish elderly people.

MATERIAL AND METHODS

to obtain original documents, electronic searches were carried out in Spanish (IME and ISOC) and international databases (MEDLINE, PsycInfo, CINAHL and EMBASE). Manual searches and reference searches were also conducted.

RESULTS

34 articles relating to 4 instruments met the inclusion criteria: the Barthel Index, the Katz Index, the Red Cross Scale of Physical Disability and the Subscale of Personal Care Activities from the OARS. Overall, the results show a large number of versions for each instrument with weak transcultural adaptation processes and without standards for their administration or interpretation. The most frequently evaluated reliability measure was interrater reproducibility. The evidence on predictive validity is extensive, but the evidence on concurrent validity and responsiveness is almost nil.

CONCLUSIONS

one version of the Barthel index and another one of the Katz index are the two versions about which the largest quantity of information has been obtained.