Sponsored by an educational grant from Ipsen
Aging, eventually associated with a decrease in quality of life (QoL) of the global population, will become one of the major public health issues in the near future. Over the past decades, life expectancy has considerably increased, mainly in western populations. Recent WHO data have reported a worldwide total of 600 million people aged 60 and older in the year 2000, a figure estimated to double by 2025 and to reach virtually 2 billion by 2050. Rather than aiming simply to live longer, people are also aspiring to undergo 'active ageing' with an emphasis on their QoL.
Significant advances in the understanding of the physiology and pathophysiology of the aging male population, as well as substantial efforts to measure related QoL, have been achieved over the past years. As a result, it is now well established that aging in healthy men entails an age-related decline in serum testosterone (ST) production.
After the age of 50, testosterone levels decline by 1% per year, and over 60 years 1 in 5 men lives with ST levels below the range for young males. Although a great interindividual variation exists among elderly men in the decline of ST levels, a large body of evidence suggests that decreased ST levels contribute, at least in some men, to age-associated physiological processes that may affect the function of multiple organ systems. Although so far less conclusive, there is progressively more evidence indicating that decreased ST levels are involved in a significant detriment in the quality of life of the aging male.
More consistent evidence exists on the benefit, in terms of signs and symptoms, of normalizing ST levels by testosterone substitution. However, there is also an increasing interest in assessing the impact of androgen substitution therapy on the restoration of QoL in older men with age-related decline in ST levels. In particular, several comparative studies using testosterone substitution have shown very promising results in improving QoL of the aging male.
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