Conclusions

In elderly men, ageing is accompanied by a decrease in objective and subjective physical function, as well as changes in body composition and bone mass. In parallel, important changes in the endocrine system occur. Testosterone administration seems to influence bone mass and perhaps muscle strength, although insufficient evidence exists to confirm that testosterone substitution in the elderly is indicated. Also, oestradiol seems to influence bone mineral density in elderly men. Although DHEA and its sulfate have been regarded as the hormone of youth, studies performed so far do not yet indicate a role for these adrenal hormones in maintaining physical functional status. DHEA, nevertheless, might have beneficial effects on cardiovascular and immunological processes. It remains unclear how hormones of the somatotropic axis contribute to the ageing process. Traditionally, the ageing process has been considered physiological and unavoidable. In recent years, however, it has become evident that it might not be necessary to accept the grim stereotype of ageing as an unalterable process of decline and loss (Fiatarone et al 1994, Rowe & Kahn 1987). When sufficient research has been done on hormonal replacement therapy in elderly men, hormonal substitution might be used to delay the ageing process and to allow us to live for a longer period in a (relatively) independent state of successful ageing.

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