Examining the Effects of Testosterone and Strength Training on Fat Mass and Functional Strength in Older Adult Males: A Systematic Review.

Abstract

This study aimed to compare whether testosterone therapy combined with strength training would lead to greater increases in fat-free mass and functional strength compared to strength training alone in biological males over 60 years old. A systematic review of randomized control trials (RCT) published between January 2013 and October 2023 was conducted. Keywords were employed to identify RCTs involving older adult males aged 60 years or older who received exogenous testosterone as a sole intervention, strength training as a sole intervention, or a combination of exogenous testosterone and strength training. Predetermined sets of inclusion and exclusion criteria were used to narrow the search. The authors critically appraised the selected articles using the Critical Appraisal Skills Programme (CASP) and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines in conducting the review. Of 6,149 articles identified initially, only 4 met the inclusion and exclusion criteria and were included in the study. These articles detailed various deliveries and dosimetries in testosterone administration. Quality assessment using the CASP indicated that the articles were valid, although they were deemed unfeasible to be applied in a local setting. Review results showed that the administration of exogenous testosterone increased fat-free mass and decreased fat mass but did not result in significant strength gains. Administering testosterone and resistance training improved functionality and strength in some studies, but the outcomes were inconsistent across studies. The increase in fat-free mass and decrease in fat mass were significantly greater than those achieved through resistance training but demonstrated similar improvements in strength and functionality.