Laughlin GA et al. (2007) Low serum testosterone and mortality in older men. J Clin Endocrinol Metab [doi:10.1210/jc.2007-1792]

A recent study has attributed low testosterone levels to earlier death in elderly men. Declining levels of serum testosterone have been considered as a factor leading to the deterioration of health in older men; however, there have been few scientific reports to back up this theory. Laughlin et al. carried out a prospective study of 794 men aged 50–91 years from 1984 to 2004 in a Southern California community. The group's median total testosterone level was 300 ng/dl.

During the study, 538 deaths occurred. Men with total testosterone levels in the lowest quartile (<241 ng/dl) had a 40% higher risk of death over the following 20 years than men with normal testosterone levels. Other risk factors, such as age, pre-existing disease, obesity, and lifestyle choices were examined, but did not explain the association of low testosterone with mortality. Low testosterone levels appeared to increase the risk of death attributable to cardiovascular and respiratory disease (hazard ratios 1.38 [95% CI 1.02–1.85] and 2.29 [95% CI 1.25–4.20], respectively).

Testosterone levels above the median for this group did not show any clear survival advantage; therefore, the authors suggest randomized, placebo-controlled trials are needed to investigate the potential of physiologic testosterone-replacement therapy to extend duration and quality of life for elderly men with testosterone insufficiency.