Aging men's health: a case-based approach

213 Pages·2005·3.942 MB·English

by  Tan, Robert S

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Aging Men’s Health
A Case-Based Approach
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Aging Men’s Health
A Case-Based Approach
Robert S. Tan, M.D.
Clinical Director
Extended Care Line
Michael E. DeBakey Veterans Affairs Medical Center
Associate Professor of Medicine (Geriatrics)
Baylor College of Medicine
Clinical Associate Professor of Family Medicine
University of Texas
Houston, Texas
Advisory Board
Men’s Health Network
Washington, D.C.
Thieme
New York • Stuttgart
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Thieme Medical Publishers,Inc.
333 Seventh Ave.
New York,NY 10001
Associate Editor:Owen Zurhellen Compositor:Techset Composition,Ltd.
Consulting Editor:Esther Gumpert Printer:Maple-Vail Book Manufacturing Group
Vice President,Production and
Electronic Products:Anne Vinnicombe
Production Editor:Becky Dille
Marketing Director:Phyllis Gold
Sales Director:Ross Lumpkin
Chief Financial Officer:Peter van Woerden
President:Brian D. Scanlan
Library of Congress Cataloging-in-Publication Data
Tan,Robert S.
Aging men’s health :a case-based approach / Robert S. Tan
p.; cm.
Includes bibliographical references and index.
ISBN 1-58890-296-X (TMP :alk. paper) -- ISBN 3-13-139391-2 (GTV :alk. paper)1. Older
men--Diseases. 2. Older men--Medical care.
[DNLM:1.Aging--Case Reports. 2.Androgens--Case Reports. 3.Geriatrics--methods--Case
Reports. 4.Men--Aged--Case Reports. 5.Men--Middle Aged--Case Reports.] I.Title.
RC952.5.T35 2005
618.97’0081--dc22
2005002486
Copyright © 2005 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is
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Important note: Medical knowledge is ever-changing. As new research and clinical experience
broaden our knowledge,changes in treatment and drug therapy may be required. The authors and
editors of the material herein have consulted sources believed to be reliable in their efforts to
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the work herein or changes in medical knowledge neither the authors,editors,nor publisher,nor any
other party who has been involved in the preparation of this work, warrants that the information
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Printed in The United States of America.
5 4 3 2 1
TMP ISBN 1-58890-296-X
GTV ISBN 3-13-139391-2
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In Thanks
I wish to thank Solvay Pharmaceuticals, University of Texas,
Baylor College of Medicine, Veterans Administration,
and the many contributors for their kind support of this work.
Special mention must be made of the patience of the editorial staff at Thieme,
in particular Owen Zurhellen and Rebecca Dille.
This book is dedicated to my aging parents and to
the many patients whose quality of life we hope to improve.
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Contents
In Thanks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . v
Foreword . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ix
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xi
Preface . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xiii
Contributors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . xv
1. Preventive Gerontology in Men’s Health: Optimal Aging Concepts
for Midlife and Beyond . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Robert S. Tan and Akira Nishikawa
2. Delaying Aging for Men: Longevity Lessons from Women . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Robert S. Tan and Meenu Jacob
3. Diagnostic Concerns and Evaluation of the Andropause in Aging Males . . . . . . . . . . . . . . . . . 21
Robert S. Tan
4. Laboratory Assessments: Implications in Diagnostics for the Andropause . . . . . . . . . . . . . . . 26
Christina Ho and Robert S. Tan
5. Androgens and Sexuality in Aging Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Kew-Kim Chew and Robert S. Tan
6. Depression in Aging Men: Are There Unique Gender-Based Therapies? . . . . . . . . . . . . . . . . . 43
Claudia A. Orengo, Ginny Fullerton, and Robert S. Tan
7. Alzheimer’s Disease in Older Men: Are There Gender-Specific Etiological
Issues and Treatments? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Robert S. Tan and Ralph N. Martins
8. The Effects of Aging, Hypogonadism, and Nutrition on Endurance and Strength . . . . . . . . . 61
Thomas Curtis Namey
9. Osteoporosis in Aging Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 73
Michelle Iannuzzi-Sucich and Pamela Taxel
10. Effect of Androgens on Muscle, Bone, and Hair in Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 83
Melinda Sheffield-Moore, Douglas Paddon-Jones, Melanie G. Cree, Darren W. Lackan,
and Randall J. Urban
11. Obesity in Aging Men and the Androgen Relationship . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 93
Robert S. Tan and Shou-Jin Pu
vii
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viii CONTENTS
12. Arthritis in Aging Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 102
Carlos A. Plata and Robert S. Tan
13. Cardiovascular Heart Disease in Older Men and the Role of Androgens . . . . . . . . . . . . . . . . . 112
Grant C. Fowler, Emma Cid, and Robert S. Tan
14. An Overview of Erectile Dysfunction in Aging Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 123
Peter Huat-Chye Lim, Perianan Moorthy, and Robert S. Tan
15. Depression, Erectile Dysfunction, and Coronary Heart Disease:
An Interlinked Syndrome in Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Robert S. Tan
16. Premature or Rapid Ejaculation: ANeurobiological Approach to Management . . . . . . . . . . . 138
Robert S. Tan and Michael Mistric
17. Prostate Cancer: Controversies and Developments in Screening and Treatments . . . . . . . . . . 143
Robert Yong and Robert S. Tan
18. Growth Hormone Replacement in Aging Men . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
Seng-Hin Teoh and Robert S. Tan
19. Bioidentical Hormone Replacement with Testosterone in Men . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Christopher B. Cutter and Robert S. Tan
20. Nutraceuticals as Preventive Medicine in Aging Men’s Health . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Bruce Biundo and Robert S. Tan
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
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Foreword
“While a gender-specific approach is often used to identify cancer, which all are of great interest to practicing col-
persistent inequalities in the status of women, the specific leagues.
situation of men, particularly of older men, also requires This book broadens the context in which we think
investigation and further studies, especially with regard to about aging men’s health and tries to fill the gap cre-
the determinants of health.” ated by the paucity of existing research data on men.
Men, Aging and Health; WHO 2001 This, in general, is a difficult issue that needs to be
addressed immediately. It will be essential to stimu-
Despite many well-recognized facts, for example, that late appropriate research for men of all ages and to
life expectancy differs between men and women, and develop comprehensive gender-specific databases
that osteoporosis and depression are no longer and suitable evaluation methods for the gender differ-
“women’s diseases,” there has been near silence about ences between men and women. Our definition of
men’s health in general among politicians, the med- gender-specific medicine and men’s health will inevi-
ical community, and the media. It is impossible to tably expand in direct proportion to research and to
understand aging and health without a gender-based the emergence of new concepts concerning the impor-
approach. From a physiological and psychosocial tance of sex and gender in health.
point of view, the determinants of health as we age are It is a privilege to write this foreword as the presi-
related to gender. It has only been a few years that dent of the International Society for Men’s Health and
aging men’s health has received increased attention in Gender (ISMH, www.ismh.org) and Editor-in-Chief of
medical research, in publication of evidence-based the Journal of Men’s Health and Gender (JMHG). The
scientific articles, and in scientific meetings such as the ISMH was established in 2000 as an international inde-
World Congress on Men’s Health (www.wcmh.info). pendent organization to provide a platform for all
Gender-sensitive and gender-specific medicine is interested organizations and to promote concepts con-
needed to provide longer and healthier lives for men cerning men’s health and gender medicine in order to
in general. contribute to the development of good practice. The
Aging Men’s Health presents the state of the art in JMHG was launched in 2004. It is an international
aging men’s health. It contains knowledge that the interdisciplinary journal offering updates on practice-
medical community needs in order to do its work pro- based issues, current research, and policy matters cov-
fessionally. Twenty chapters written by leaders in the ering all aspects of men’s health and gender medicine.
field encompass the information needed by practicing This book is an invaluable research-oriented source
colleagues and academic institutions interested in of knowledge that addresses, and promises to influ-
gender medicine, preventive gerontology, geriatrics, ence, the medical care and management of aging men.
and men’s health. This information is needed today
more than ever. The book provides the most recent
information on longevity and cardiovascular health. SIEGFRIEDMERYN, M.D.
It gives straight answers on the controversies and Professor of Medicine
effects of androgen and growth hormone replace- President of the ISMH
ment. It includes chapters on andropause, erectile Editor-in-Chief, JMHG
dysfunction, the depression–erectile dysfunction–cor- Center for Advanced Medical Education
onary heart disease (D.E.C.) syndrome, and prostate Medical University of Vienna, Austria
ix