The ageing males' symptoms scale for Chinese men: reliability,validation and applicability of the Chinese version

In this study, the ageing males' symptoms (AMS) scale was translated into Chinese following methodological recommendations for linguistic and cultural adaptation. This study aimed to confirm the reliability, validation and applicability of the simplified Chinese version of the scale (CN-AMS) in older Chinese men, a free health screening for men older than 40 years was conducted. All participants completed a health questionnaire, which consisted of personal health information, AMS scale, the generic quality of life (QoL) instrument SF36 and the Beck Depression Inventory (BDI). The fasting blood samples of participants were collected on the day of completing the health questionnaire. Serum total testosterone (TT), albumin and sex hormone-binding globulin levels were measured and the level of free testosterone was calculated (calculated free testosterone, CFT). A total of 244 men (mean age: 52 ± 7.3 years, range: 40-79 years) were involved in the investigation and provided informed consent before their participation. The reliability of CN-AMS was analysed as internal consistency reliability (Cronbach's alpha was 0.91) as well as a 4-week-interval test-retest stability (Pearson's correlation was 0.83) and found to be good. The validation of CN-AMS was analysed as the internal structure analysis (Pearson's correlation between total score and each item score r = 0.48-0.75), total-domain-correlation (among the three domains r = 0.47-0.68, p < 0.01; domains with the total score r = 0.81-0.88, p < 0.01), and cross-validation with other scales (with SF36 r = -0.59, p < 0.01; with BDI r = 0.50, p < 0.01). Androgen deficiency (AD) was defined as the presence of three sexual symptoms (decreased frequency of morning erections, sexual thoughts and erectile dysfunction) in combination with TT < 11 nmol/L and CFT < 220 pmol/L, and the sensitivity and specificity for CN-AMS was 68.8 and 6.8% respectively. The CN-AMS had sufficient sensitivity in screening AD of older men, but the low specificity made it unsuitable to be adopted as the diagnostic criteria. The scanning capability of AMS scale for AD has the downward trend with ageing and a hypothesis is proposed to give a possible reason for the new finding.