The number of older adults over 65 years of age is expected to increase to almost 100 million in the US by 2050, more than double the current figure of 46 million. Advanced age is associated with increased frailty among older Americans and often leads to increased disability, hospitalization, institutionalization, and, eventually, mortality. In search of means to improve age-related risks for adverse health outcomes, the question of restoring diminishing sex hormones has gathered much interest and has led to the practice of sex hormone replacement therapies in older men. Recent data suggest that androgen prescription rates in the US for men older than 60 years of age quadrupled from the years 2001 to 2011. While prescription sales of testosterone have increased from $150 million in 2000 to $1.8 billion in 2011, a significant portion of men prescribed testosterone replacement therapy did not meet the laboratory criteria for hypogonadism. While some clinical trials reported an association between testosterone insufficiency in older men and increased risk of death, the exact effects and consequences of testosterone replacement therapy, specifically in older men, remain unclear. This review is aimed at discussing the possible benefits and complications of testosterone replacement therapy in older men over 60 years of age.

中文翻译：

---

老年男性的睾酮替代疗法是否有效且安全？

到 2050 年，美国 65 岁以上老年人的数量预计将增加到近 1 亿，是目前 4600 万的两倍多。高龄与美国老年人的虚弱程度增加有关，并且往往导致残疾、住院、机构化以及最终死亡率增加。在寻找改善与年龄相关的不良健康结果风险的方法时，恢复减少的性激素的问题引起了极大的兴趣，并导致在老年男性中进行性激素替代疗法。最近的数据表明，美国 60 岁以上男性的雄激素处方率从 2001 年到 2011 年翻了两番。虽然睾酮的处方销售额从 2000 年的 1.5 亿美元增加到 2011 年的 18 亿美元，很大一部分开具睾丸激素替代疗法的男性不符合性腺功能减退症的实验室标准。虽然一些临床试验报告了老年男性睾酮不足与死亡风险增加之间的关联，但睾酮替代疗法的确切效果和后果，尤其是老年男性，仍不清楚。本综述旨在讨论睾酮替代疗法对 60 岁以上老年男性的可能益处和并发症。