Similarly, declines in gonadal function in men are associated with changes in strength, function, and loss of bone mass. Small studies have suggested that testosterone replacement improves but does not eliminate these changes. These studies are not as extensive as those examining estrogen replacement in women. Adrenal activity increases with aging.
Although this may change the approach to treatment of diabetes or hypertension, no direct therapy for this change has been examined. Skeletal metabolism also changes with age, leading to a loss of bone mass and a predisposition to fracture, with a subsequent loss of independence. Vitamin D supplementation and pharmacologic interventions have been demonstrated to reduce fracture incidence in older women and presumably prolong independence.
The effects of these therapies on fracture incidence in older men have not been examined. Lastly, glucose metabolism changes in older individuals. Therapy for older type 2 diabetics should generally recognize these changes. Obesity will generally be less of a problem in older type 2 diabetes. Other causes of insulin resistance are generally more important. Skip to main content. Research Article Beckman Conference. Abstract Physiologic systems have substantial reserves in younger individuals.
View inline View popup. Gonadal Function in Women Menopause is a universal finding in women by the mid sixth decade of life. Changes associated with postmenopause. Gonadal Function in Men Serum testosterone decreases with aging in cross-sectional 61 62 as well as longitudinal studies Adrenal Function Adrenal medullary function and baseline serum epinephrine and norepinephrine concentrations apparently increase with advancing age.
Thyroid Function Changes in the thyroid gland with aging are not constant and probably depend on endemic iodine intake and rates of goiter Growth Hormone Pituitary function, LH, follicle-stimulating hormone, and thyroid-stimulating hormone decline with age. Diabetes Type 2 The prevalence of type 2 diabetes is age-related 98 99 Other Changes Associated with Aging IL-6 is an inflammatory and postinflammatory cytokine with multiple effects A profile of older Americans: US Department of Commerce.
Endocrine Function in Aging
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Clin Chem ; Relation of serum total cholesterol and high-density lipoprotein cholesterol percentage to the incidence of definite coronary events: Am J Cardiol ; Multiple coronary heart disease risk factors are associated with menopause and influenced by substitutive hormonal therapy in a cohort of French women. Atherosclerosis ; Differences in low density lipoprotein subfractions and apolipoproteins in premenopausal and postmenopausal women.
Influence of the perimenopause on cardiovascular risk factors and symptoms of middle-aged healthy women. Arch Intern Med ; Postmenopausal estrogen therapy and cardiovascular disease. Postmenopausal estrogen use, cigarette smoking, and cardiovascular morbidity in women over Mayo Clin Proc ; Postmenopausal estrogen use and mortality. Results from a prospective study in a defined, homogeneous community. Barrett-Connor E , Miller V. Estrogens, lipids and heart disease. Postmenopausal hormone therapy and mortality.
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International Journal of Endocrinology
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In this issue Vol. Table of Contents Index by author. The Endocrinology of Aging. Clinical Chemistry Aug , 45 8 ;. Physiology and Pathophysiology of Bone Remodeling. Closing the Loop from Bench to Bedside. An enhanced focus on this aspect of endocrinology and metabolism will sensitize health care providers, including endocrinologists, to the importance of evaluating and treating elderly endocrine patients differently. Subtle nuances of geriatric care will be understood and implemented on a wider scale.
This will help improve both the endocrine and metabolic treatment provided by geriatricians and gerontologists, as well as the geriatric care given by endocrinologists. In spite of the well understood need for studying geriatrics and gerontology, comparatively less attention is paid to this important specialty. In consequence, a significant proportion of our patients may be deprived of optimal endocrine and medical care.
Is this because the elderly population is not as vocal as younger adults in demanding health care? Or perhaps because geriatrics is not as attractive to the media as compared to women's health or child health? Can it be due to the fact that elderly people find it difficult to access, and pay for, health care or medical consultations?
Or is it simply because most physicians do not have simple guidelines to follow while managing geriatric patients?
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The teaching curriculum in internal medicine and endocrinology does not provide much emphasis on this aspect of science, and geriatrics is not well developed as a specialty in India and many other countries. In countries as diverse as the United Kingdom and India, physicians in training express their disinclination towards the study of geriatrics. A study from the UK reports that medical students are unequivocal in feeling that geriatric practice, while rewarding, lacks earning potential and prestige. The same study revealed that diabetology and endocrinology were ranked second and third respectively.
The six-country South Asian Consensus guidelines authored by Baruah et al. Covering the demography, pathophysiology, screening, investigations, non- pharmacological therapy, and pharmacological management of diabetes in geriatric patients, the guidelines represent a milestone in South Asian endocrinology. Experts from six South Asian countries have pooled their expertise and experience, as well as reviewed available evidence, to prepare practical, easy-to understand, and easy to follow guidelines for diabetes in old age. Following the Endocrine Society of India guidelines for the management of thyroid nodules, published by Unnikrishan et al.
This effort on part of Indian J Endocrinol Metab will continue in the future, through review articles, consensus statements, and guidelines. It is hoped that these guidelines will be of help to endocrinologists, geriatricians and physicians alike. They should sensitize and stimulate all stakeholders to improve and optimize diabetes care for geriatric patients. This should translate into better health care for all our geriatric citizens.
Endocrine Function in Aging
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