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Popular culture often equates testosterone with virility, strength, and the macho male physique. Viewed by some as an "antiaging tonic," testosterone's reputation and increased use by men of all ages in the United States have outpaced the scientific evidence about its potential benefits and risks. In particular there has been growing concern about an increase in the number of middle-aged and older men using testosterone and the lack of scientific data on the effect it may have on aging males. Studies of testosterone replacement therapy in older men have generally been of short duration, involving small numbers of participants and often lacking adequate controls. Testosterone and Aging weighs the options of future research directions, examines the risks and benefits of testosterone replacement therapy, assesses the potential public health impact of such therapy in the United States, and considers ethical issues related to the conduct of clinical trials. Testosterone therapy remains an attractive option to many men even as speculation abounds regarding its potential.
The first edition of "Textbook of Men's Health" did much to establish and define the scope of the emerging subspecialty of aging men's health. This revised and updated edition, with new sections on basic sciences and sexual dysfunction, has a small but significant change of approach - reflected in the new title. The central mission of the new editi
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
While menopause in women is a well-established and well documented phenomenon, the andropause in men is a relatively new concept. The terms male menopauseand andropausesuggest that this is an abrupt phenomenon related to a sudden deprivation of sex hormones. Unlike the menopause, which has a relatively sudden onset, the andropause appears to be a gradual process. It has been hypothesized that an androgen deficiency might develop with aging. Androgens and the Aging Male explores this hypothesis. The book focuses on the gradually progressive problems related to the decline in androgens that can occur with advancement of age. It examines the debate about the extent to which an age-dependent decline in androgens leads to health problems that affect or impair the quality of life, and the theory behind it. In addition, it reviews studies evaluating the effects of androgen supplementation. Androgens and the Aging Male comprehensively covers androgen function and how it changes over time.
New developments in testosterone therapy are summarized here by internationally renowned experts. They review both basic and clinical knowledge in fourteen chapters. The book begins with the biochemistry of testosterone, its biosynthesis, metabolism and mechanisms of action in target organs. Three chapters deal with specific aspects of testosterone action, namely its role in spermatogenesis, its psychotropic effects and its effects on bones. Syndromes caused by androgen resistance are described in order to highlight the importance of properly functioning enzymes and receptors in the target organs. Causes and symptoms of male hypogonadism, the major indication for testosterone treatment, are described. Five chapters are devoted to the pharmacology, pharmacokinetics and clinical uses and abuses of testosterone preparations. The new transdermal testosterone application is described in detail. Side effects of testosterone treatment are reviewed. The possible role of androgens in the development of prostatic hypertrophy and carcinoma is discussed extensively since this question is of major concern to the clinician.
Awareness of the importance of sexuality and its disorders in the aging population is increasing as the proportion of older people increases. Based in part on the author's clinical experience and research at Mount Sinai Medical Center in New York, this book presents an up-to-date overview of the sexuality of aging men in health and illness, within a multidimensional conceptual framework. It takes into account physiological, psychological, interpersonal, and social influences. The book also discusses the impact of medical illness, psychopathology, and drugs, with a review of coping strategies in shaping individual sexual responses to aging and disease. The author incorporates many case studies and vignettes, and devotes a chapter to the sexuality of older gay men. A balanced account of medical and psychosocial evaluation and treatment concludes the book, which will be of broad interest to clinicians and students interested in sexuality and aging.
Handbook of the Psychology of Aging, Eighth Edition, tackles the biological and environmental influences on behavior as well as the reciprocal interface between changes in the brain and behavior during the course of the adult life span. The psychology of aging is important to many features of daily life, from workplace and the family, to public policy matters. It is complex, and new questions are continually raised about how behavior changes with age. Providing perspectives on the behavioral science of aging for diverse disciplines, the handbook explains how the role of behavior is organized and how it changes over time. Along with parallel advances in research methodology, it explicates in great detail patterns and sub-patterns of behavior over the lifespan, and how they are affected by biological, health, and social interactions. New topics to the eighth edition include preclinical neuropathology, audition and language comprehension in adult aging, cognitive interventions and neural processes, social interrelations, age differences in the connection of mood and cognition, cross-cultural issues, financial decision-making and capacity, technology, gaming, social networking, and more. - Tackles the biological and environmental influences on behavior as well as the reciprocal interface between changes in the brain and behavior during the course of the adult life span - Covers the key areas in psychological gerontology research in one volume - Explains how the role of behavior is organized and how it changes over time - Completely revised from the previous edition - New chapter on gender and aging process
The significance of hormone action in psychiatry has been long studied, now including the psychiatric effects of hormones on the aging process. This clinical reference addresses the hormonal basis of mental disorders in older people. Hormones influence a wide range of states and conditions, from pain tolerance and anorexia to attention, mood, immunity, cardiovascular and cognitive function, schizophrenia and Alzheimer's disease. Written by an eminent team of psychiatrists, psychologists, geriatricians and neuropharmacologists, this book brings together established information and findings in four sections: • An overview of the basic science of neurosteroids • Sex difference and the roles that cortisol, thyroid hormone, and the sex steroids estrogen, progesterone, dehydroepiandrosterone and testosterone play in common mental disorders and pain sensitivity • Psychoneuroimmunology in relation to age • Sex differences and hormones in psychotropic drug metabolism in the elderly.
Current demographic statistics show that modern societies are rapidly aging. Aging in general is accompanied by an increased susceptibility to physical and mental disease as well as an increased risk of mortality. Health care costs are expected to rise enormously. Therefore, successful aging with less disease burden and dependency is emerging as one of the most crucial health care goals of the upcoming decades. In this dissertation, endocrine health and its age-related changes are focused. In men, a continuous decline of sex steroids such as testosterone or dehydroepiandrosterone occurs around the ages of 40 years leading to psychological and physical adaptation processes. The presented results indicate an integrated hormone parameter consisting of declining sex steroids as a useful biomarker of healthy aging in men. Furthermore, psychosocial risk factors such as depressive symptoms or chronic stress were shown to be associated with an intensified age-related decline of this integrated hormone parameter. In addition, the age-related deterioration in body composition was also shown to be associated with psychosocial risk and protective factors.