Endocrine Society Scientific Statement Distinguishes Normal Aging from Endocrine Disease

A new Scientific Statement released today by the Endocrine Society highlights the differences between aspects of aging that are normal and sometimes over-treated, and those such as menopausal symptoms and osteoporosis that can be treated and deserve more attention.

“Hormones and Aging: An Endocrine Society Scientific Statement,” reviews the current state of research on hormonal changes with age. The statement focuses on common endocrine-related changes in older people including menopause and the development of diabetes, osteoporosis and thyroid disorders. The goal of the statement is to inform future research on the prevention and treatment of age-associated endocrine health problems.

“Understanding the factors that impact hormonal changes with age and when to correct them is an exciting area of research. The number of older people is increasing worldwide, and it is important that we preserve their health and quality of life,” says writing group chair Anne Cappola, MD, of the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Penn. “Differentiating normal age-related health changes from those related to an endocrine condition informs when to treat and more importantly when not to treat age-associated symptoms.”

Key points from the statement:

  • Menopausal symptoms are common, vary in degree of discomfort and can be effectively treated with a variety of medications, yet these symptoms are still undertreated.
  • More research is needed to decide when older adults should receive testosterone-replacement therapy and to understand the adverse effects of the treatment on heart and prostate disease.
  • More data is needed to determine the optimal treatment goals in older people with diabetes.
  • Fractures are often not recognized as being related to osteoporosis, and as a result, most older patients with a fracture are not treated to prevent their next fracture.
  • Methods to distinguish between age-associated changes in thyroid function and early hypothyroidism are needed.
  • No therapy to increase growth hormone secretion or action is currently approved as an anti-aging intervention, and the risks may outweigh the benefits.
  • Some research has shown benefits of vitamin D supplementation in older adults, but standardized guidelines on appropriate vitamin D levels are lacking.

“Understanding the factors that impact hormonal changes with age and when to correct them is an exciting area of research. The number of older people is increasing worldwide, and it is important that we preserve their health and quality of life.”

Anne Cappola, MD, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa.

“The statement discusses how menopausal symptoms and osteoporosis are often undertreated in the older population despite evidence that the treatments are both safe and effective,” Cappola said. “Treating these symptoms and screening for common endocrine conditions that develop or worsen with age could really improve the quality of life for older people.”

The study authors will present the statement’s key findings during an ENDO 2023 news conference today.

Other statement authors are Richard Auchus of the University of Michigan and LTC Charles S. Kettles Veteran Affairs Medical Center in Ann Arbor, Mich.; Ghada El-Hajj Fuleihan of the American University of Beirut in Beirut, Lebanon; David Handelsman of the University of Sydney and Concord Hospital in Sydney, Australia; Rita Kalyani of John Hopkins School of Medical in Baltimore, Md.; Michael McClung of Oregon Osteoporosis Center in Portland, Ore. and the Australian Catholic University in Melbourne, Australia; Cynthia Stuenkel of the University of California San Diego School of Medicine in La Jolla, Calif.; Michael Thorner of the University of Virginia in Charlottesville, Va., and Brigham and Women’s Hospital in Boston, Mass.; and Joseph Verbalis of the Georgetown University Medical Center in Washington, D.C.

The statement, “Hormones and Aging: An Endocrine Society Scientific Statement,” was published online in the Society’s Journal of Clinical Endocrinology & Metabolism.

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