Frailty and muscle function: role for testosterone?

Frailty is a clinical syndrome characterised by reduced physiologic reserve affecting multiple organ systems and is associated with increased risk of falls, fractures, hospitalisation and death. The impact of agerelated physical frailty on well-being and health in older men and the potential for prevention and treatment are beginning to be explored. Frailty is multifactorial with aging, comorbidity, sarcopenia, and endocrine immune dysfunction contributing to the condition. Falling testosterone levels with advancing age are associated with muscle loss (sarcopenia) and strength. Among the various therapeutic options being considered, testosterone supplementation offers promise due to its anabolic effects on muscle. In this review, we discuss the syndrome of frailty, its relationship with low testosterone and the effects of testosterone supplementation in healthy and unhealthy/frail older men on muscle mass, strength and physical performance.