Androgens and Selective Androgen Receptor Modulators to Treat Functional Limitations Associated With Aging and...

Area of Science:

• Endocrinology and Gerontology
• Pharmacology

Background:

• Androgens like testosterone and selective androgen receptor modulators (SARMs) are explored for treating age-related functional decline.
• Evidence from sex differences and athletic use highlights the anabolic potential of androgens.

Approach:

• This review synthesizes preclinical data, mechanisms of action, and randomized controlled trials of testosterone, other androgens, and nonsteroidal SARMs.
• It examines effects on body composition, physical function, bone density, sexual health, mood, and anemia.

Key Points:

• Testosterone therapy demonstrably increases lean body mass, muscle strength, and aerobic capacity across diverse populations.
• Benefits include improved bone mineral density, sexual function, and mood, though walking speed improvements are inconsistent.
• Cardiovascular and prostate safety require further long-term investigation; functional improvements need better translation strategies.

Conclusions:

• Testosterone and SARMs offer promise for function-promoting therapies, but efficacy in reducing fractures, falls, and diabetes progression is unproven.
• Future research should focus on combining androgen therapy with exercise to achieve meaningful functional gains.