Table 2.

Gaps in Our Knowledge and Opportunities for Future Investigations of Testosterone and Selective Androgen Receptor Modulators as Function-Promoting Therapies

Adequately powered placebo-controlled trials of longer duration are needed to address the following questions:

1. Can testosterone treatment alone induce clinically meaningful improvements in performance-based measures of physical function, such as walking speed? Are testosterone-induced improvements in skeletal muscle mass and maximal voluntary strength associated with downstream improvements in how a person “...functions or feels”, assessed using validated patient-reported outcome (PRO) measures?

2. Are testosterone-induced improvements in skeletal muscle mass associated with other health benefits, such as reducing the incidence of type 2 diabetes mellitus; inducing glycemic remission in older adults with type 2 diabetes mellitus; improving stress urinary incontinence; preventing falls and fractures in at-risk older adults?

3. Can testosterone treatment prevent or retard disease progression in older men with preclinical or early Alzheimer’s Disease?

4. Is testosterone treatment efficacious in improving depressive symptoms and inducing remission of late-life persistent depressive disorder (dysthymia) in older men with hypogonadism?

5. Can multidimensional functional exercise training augment and translate testosterone-induced muscle mass and strength gains into clinically meaningful improvements in performance-based measures of physical function and in how a person “...functions and feels”?