Depression in older men has been associated with low circulating testosterone but data from prospective studies is limited and no previous studies have included data on testosterone’s bioactive metabolites (dihydrotestosterone and estradiol).
Longitudinal, prospective study of3179 older men followed up for nearly 10 years.
Low serum testosterone was associated with an 86% increased hazard of depression (HR 1.86, 95%CI 1.05–3.31) once relevant demographic, clinical and biochemical factors were taken into account.
Serum dihydrotestosterone, estradiol and calculated free testosterone were not associated with risk of depression.
Clinical trials of testosterone treatment in older men without pathological hypogonadism are needed to determine if testosterone has a role in treating and/or preventing depression in later life.