A new study finds that older men with low testosterone may fall more often.

Two-thousand senior men recently took part in a men’s health study. Participants were tested for physical performance at the beginning of the study. Then, over a four-year period were seen every four months. They self-reported falls during these visits.

Researchers found that the lower level of testosterone, the greater risks.

"Men with low testosterone also had about a 40 percent increased risk of falls," Dr. Lynn Marshall said.

There was one puzzling twist to this study. While men over 80 fell more often than those younger than 80 - the octogenerians’ falls appeared to be related more to low muscle mass than to low testosterone levels.

FAST FACTS:

The-third of Americans over 65 experience a fall each year.

Men are more likely than women to die from a fall.

Researchers have found men with low levels of testosterone have a 40 percent higher risk for falls than those with the high levels of testosterone.

Falls and the Elderly
Falls are a leading cause of injury to older Americans. The Centers for Disease Control and Prevention estimates one-third of those over 65 experience a fall each year. About 1.8 million elderly Americans are treated in hospital emergency rooms for injuries sustained in a fall. 460,000 of them are hospitalized. Treatment for fall-related injuries cost about $20.2 billion annually. In some cases, severe injury from a fall (like a hip fracture) can lead to a loss of independence and temporary or permanent placement in a residential care facility.

Falls are the leading cause of injury-related death for older folks. In 2003, about 13,700 men and women 65 and older died from injuries sustained from a fall. Men are more likely than women to die from a fall.

The majority of falls occur in the home. Researchers report up to 45 percent of falls at home are caused by environmental hazards (like a stairway, loose carpeting or furniture obstructing the pathway). A history of falls, balance disorders or gait problems increases the risk of falling. Falls are also more common in patients over 80 and those with muscle weakness (especially lower extremity weakness), vision impairments, arthritis or cognitive deficits, people who use assistive devices or walking aids and those who use certain medications.

Men, Testosterone and Falls
As men age, levels of the hormone, testosterone, decline. Older men also tend to have less muscle mass and an increased risk for falls. So, researchers at Oregon Health & Science University, wanted to find out if there was any relationship between lower levels of testosterone, decreased muscle mass and risk for falls.

The investigators measured serum (blood) levels of testosterone and muscle mass of 2,587 men and followed the group for about four years. Participants were asked to keep a log of how often they fell.

The researchers found 56 percent of men reported at least one fall. Men with the lowest levels of testosterone had a 40 percent higher risk for falls than those with the highest levels of testosterone. The higher risk for falls remained even when researchers eliminated muscle strength as a possible factor. More importantly, the lower testosterone/increased fall risk appears to be strongest for the younger men (65 to 70 years). After 70, the association between testosterone levels and falls appears to be less apparent.

Epidemiologist, Lynn Marshall, Sc.D., says some men ask about the need for testosterone replacement as they age. The study doesn't provide enough evidence to support the use or make recommendation for or against testosterone for older men. The next phase of study is to find out what role testosterone may play in aging risks and who may best benefit from replacement therapy.

AUDIENCE INQUIRY
For general information on falls and fall prevention:
American Academy of Orthopaedic Surgeons, http://orthoinfo.aaos.org
Centers for Disease Control and Prevention, http://www.cdc.gov/ncipc/factsheets/adultfalls.htm
National Institute on Aging, http://www.nia.nih.gov, or http://nihseniorhealth.gov