CoChat
Sign Up
Cited by 158Hormonal and reproductive studiesTreatment of Major DepressionMenopause: Health Impacts and Treatments

Low Free Testosterone Concentration as a Potentially Treatable Cause of Depressive Symptoms in Older Men

Almeida, Osvaldo P., Yeap, Bu B., Hankey, Graeme J., Jamrozik, Konrad, Flicker, Leon·2008·Archives of General Psychiatry
DOI 10.1001/archgenpsychiatry.2007.33
Open this paper in CoChat — free account

Abstract

CONTEXT: Serum concentrations of gonadal hormones have been associated with various measures of well-being, but it is unclear whether their association with mood is confounded by concurrent physical morbidity. OBJECTIVE: To determine whether the association between serum testosterone concentration and mood in older men is independent of physical comorbidity. DESIGN: Cross-sectional study. SETTING: Community of Perth, Western Australia. PARTICIPANTS: A community sample of men aged 71 to 89 years. MAIN OUTCOME MEASURES: We used the 15-item Geriatric Depression Scale (GDS-15) to assess depressed mood. Clinically significant depression was defined a priori as a GDS-15 score of 7 or greater. Physical health was assessed using the weighted Charlson index and the Physical Component Summary score of the 36-Item Short Form Health Survey. RESULTS: Of 3987 men included in the study, 203 (5.1%; 95% confidence interval [CI], 4.4%-5.8%) had depression. Participants with depression had significantly lower total and free testosterone concentrations than nondepressed men (P < .001 for both). However, they were also more likely to smoke and to have low educational attainment, a body mass index categorized as obese, a Mini-Mental State Examination score less than 24, a history of antidepressant drug treatment, and greater concurrent physical morbidity. After adjusting for these factors and for age, men with depression were 1.55 (95% CI, 0.91-2.63) and 2.71 (95% CI, 1.49-4.93) times more likely to have total and free testosterone concentrations, respectively, in the lowest quintile. CONCLUSIONS: A free testosterone concentration in the lowest quintile is associated with a higher prevalence of depression, and this association cannot be adequately explained by physical comorbidity. A randomized controlled trial is required to determine whether the link between low free testosterone level and depression is causal because older men with depression may benefit from systematic screening of free testosterone concentration and testosterone supplementation.

Integrity signals

Registry

Crossref · 10.1001/archgenpsychiatry.2007.33

Cites

4 of 4 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Calculated free T has a weak inverse association with depressive mood, independent of physical comorbidity.

    “In the same cohort of men, a weak inverse association between calculated free T and depressive mood was observed, independent of physical comorbidity [235].”

    From Role of sex hormone-binding globulin in the free hormone hypothesis and the relevance of free testosterone in androgen physiology (2022) · cites this paper as [235]

  • Numerous estimating equations have been described, including bioavailable testosterone, free androgen index, and free testosterone index (Vermeulen method), with results suggesting high correlations with direct assays.

    “Numerous estimating equations have been described in the literature including bioavailable T (non-SHBG bound T), free androgen index (FAI; 100T/SHBG), and free T index (Vermeulen method), among others, with results suggesting high correlations to direct assays.”

    From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [102]

  • In the largest study evaluating predictive accuracy of free testosterone calculations, Sartorius and colleagues concluded that empirical methods (Ly, Sartorius) are most concordant, while other estimations (Vermeulen, Nanjee and Wheeler, Sodergard) overestimate the true value.

    “In the largest study evaluating predictive accuracy of fT calculations, Sartorius and colleagues concluded that empirical methods (Ly, Sartorius) of calculated fT are most concordant, with other estimations (Vermeulen, Nanjee and Wheeler, Sodergard) resulting in overestimation of the true value.”

    From Challenges in Testosterone Measurement, Data Interpretation, and Methodological Appraisal of Interventional Trials (2016) · cites this paper as [102]

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Authors
Almeida, O. P., Yeap, B. B., Hankey, G. J., Jamrozik, K., & Flicker, L.
Affiliations
The University of Western Australia (AU)
ORCID
Venue
Archives of General Psychiatry
Publisher
American Medical Association (AMA)
Published
2008-03-01
Volume
65
Issue
3
Pages
283
ISSN
0003-990X (ISSN-L)
DOI
10.1001/archgenpsychiatry.2007.33
OpenAlex
W2137609530
Cited by
158
References
4
Citations by year
2026: 1 · 2025: 6 · 2024: 11 · 2023: 3 · 2022: 9 · 2021: 6 · 2020: 9 · 2019: 8 · 2018: 9 · 2017: 7 · 2016: 3 · 2015: 7 · 2014: 8 · 2013: 14 · 2012: 11
FWCI
10.86
Type
journal article
Language
en
Open access
closed
Locations
  • Archives of General Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • UWA Profiles and Research Repository (UWA) (submittedVersion)
  • Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Menopause: Health Impacts and Treatments
Keywords
free testosterone, depression, older men, serum testosterone, gonadal hormones, somatic comorbidity, testosterone supplementation, Geriatric Depression Scale, obesity, smoking, cognitive impairment
MeSH terms
Affect, Age Factors, Aged, Aged, 80 and over, Cross-Sectional Studies, Depression, Humans, Male, Testosterone

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review