Aging men- Challenges ahead

(整期优先)网络出版时间:2001-03-13
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Theprolongationoflifeexpectancyandthedrasticreductionoffertilityratearetheprimarycauseofanagingworld.Itisprojectedthattheelderly(above65)willincreasewithinthenext25yearsby82%,whereasthenewbornonlyby3%.Despitetheenormousmedicalprogressduringthepastfewdecades,thelastyearsoflifearestillaccompaniedbyincreasingillhealthanddisability.Theabilitytomaintainactiveandindependentlivingforaslongaspossibleisacrucialfactorforaginginhealthanddignity.Therefore,thepromotionofhealthyagingandthepreventionofdisabilityinmen,mustassumeacentralroleinmedicalresearchandmedicalpracticeaswellasintheformulationofnationalhealthandsocialpolicies.Effectiveprogramspromotinghealthandagingwillensureamoreefficientuseofhealthandsocialservicesandimprovethequalityoflifeinolderpersonsbyenablingthemtoremainindependentandproductive.Themostimportantanddrasticgenderdifferencesinagingarerelatedtoorgansandorsystemsdependantorinfluencedbyreproductivehormones.Indistinctiontothecourseofreproductiveaginginwomen,withtherapiddeclineinsexhormonesandexpressedbythecessationofmenses,agingmenexperienceaslowandcontinuousdeclineofhormones.Thisdeclineinendocrinefunctioninvolves:Adecreaseoftestosterone,dehydroepiandrosterone(DHEA),oestrogens,thyroidstimulatinghormone(TSH),growthhormone(GH),insulin-likegrowthfactor-1(IGF-1),andmelatonin.ThisdecreaseisconcomitantwithanincreaseofLHandFSH.Inadditionsexhormonebindingglobulin's(SHBG)increasewithageresultinginfurtherloweringtheconcentrationsoffreebiologicallyactiveandrogens.Interventionssuchashormonereplacementtherapymayprevent,delayoralleviatethedebilitatingconditionswhichmayresultfromsecondarypartialendocrinedeficiency.Primaryandsecondarypreventivestrategiessuchasthepromotionofasafeenvironment,healthylifestyleincludingp