Prospective longitudinal study of testosterone and incident depression in older men: the Health In Men Study

Ford, Andrew H., Yeap, Bu B., Flicker, Leon, Hankey, Graeme J., Chubb, S. A.Paul, Handelsman, David J., Golledge, Jonathan, and Almeida, Osvaldo P. (2016) Prospective longitudinal study of testosterone and incident depression in older men: the Health In Men Study. Psychoneuroendocrinology, 64. pp. 57-65.

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Abstract

Background: Depression in older men has been associated with low circulating testosterone concentration but data from prospective studies are limited.

Methods: We conducted a prospective longitudinal study in a community representative cohort of 3179 older men free of clinically significant depressive symptoms at baseline. The main objective of this study was to determine if low serum testosterone, dihydrotestosterone and estradiol concentrations are associated with the development of depressive symptoms. Incident depression was assessed with the Patient Health Questionnaire and via an electronic health record database (The West Australian Data Linkage System). The main exposures of interest were serum testosterone, dihydrotestosterone and estradiol measured by liquid chromatography-mass spectrometry and calculated free testosterone in baseline blood samples (collected between 2001 and 2004).

Results: One hundred and thirty five men (4.2%) developed depression over a median follow up time of 9.4 years (range 8.4-10.9). Men with incident depression were older (median age 77.7 vs 76.1 years, z=-3.82, p=0<0.001) and were more likely to have cardiovascular disease (43.0% vs 32.6%, χ2=6.32, p=0.012) and diabetes (22.2% vs 13.2%, χ2=8.95, p=0.003). Low serum total testosterone (<6.4nmol/L) was associated with incident depression (HR 2.07, 95%CI 1.17-3.68) and this remained significant after adjustment for relevant potential confounding factors (HR 1.86, 95%CI 1.05-3.31). Low serum dihydrotestosterone, estradiol and calculated free testosterone were not associated with risk of depression.

Conclusions: Low serum total testosterone, but not calculated free testosterone, was associated with incident depression in this sample of older men.

Item ID: 49351
Item Type: Article (Research - C1)
ISSN: 1873-3360
Keywords: testosterone, depression, older men
Funders: National Health and Medical Research Council (NHMRC), Queensland Government (QG), Townsville Private Practice Fund
Projects and Grants: NHMRC Practitioner Fellowship 1019921, QG Senior Clinical Research Fellowship
Date Deposited: 12 Jun 2017 05:32
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110308 Geriatrics and Gerontology @ 50%
11 MEDICAL AND HEALTH SCIENCES > 1117 Public Health and Health Services > 111714 Mental Health @ 50%
SEO Codes: 92 HEALTH > 9202 Health and Support Services > 920209 Mental Health Services @ 100%
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