(064) TESTOSTERONE THERAPY IS PROTECTIVE AGAINST FALL RISK

Abstract Introduction Falls continue to be a prominent cause of injury and disability in the elderly. One in three adults 65 and older will fall each year. A significant number of these accidents are severe enough to result in an emergency room visit. Higher levels of endogenous testosterone are protective against falls in elderly men. Objective This study aims to evaluate the relationship between Testosterone Therapy (TTh) and fall risk in elderly men. Methods We identified elderly male patients (65+) receiving Testosterone Therapy at a large university hospital from 9/2010 to 9/2022. We found 6151 patients who were tracked for falls that prompted emergency room visits. As a presumed positive control, we also identified elderly male patients with metastatic and/or castrate resistant prostate cancer presumed to be receiving androgen deprivation therapy who fell (n = 415). We hypothesized that fall incidence would be greater in this chemically hypogonadal population. Fall incidence rates were then calculated against national age-adjusted fall data for men to yield the standardized incidence ratios (SIR) and the 95% confidence interval range (CI). SIR and CI were calculated using SPSS. Results The incidence rate of men aged 65 years and older on TTh requiring emergency room visits for fall injuries was found to be 3.04% at our university hospital. This significantly deviates (p < .05) from the national age-adjusted rate of 6.05%. The SIR was 0.502 (95% CI [0.43-0.58]), indicating that the patients on TTh faced at least a 43% lower deviation from the expected rate. Chemically hypogonadal men in the same demographic demonstrated a 5.09% rate of emergency room visits for fall injuries at our university hospital, which, surprisingly, was comparable to the national expectation. Conclusions We demonstrate that elderly men on TTh are at a lower risk of falls, resulting in fewer emergency room visits compared to the general population. This is consistent with some of the protective factors demonstrated in men with high levels of endogenous testosterone. Although we hypothesized that chemically hypogonadal men would demonstrate higher fall risk, our negative finding may be limited by lack of stratification of men on intermittent v. continuous androgen deprivation. Future studies should focus on the use of TTh in a blinded prospective manner to better define its efficacy regarding fall prevention. Disclosure No.