TOM: Testosterone in Older Men With Sarcopenia

Inclusion Criteria: * Community dwelling, ages 65 and older * Self-reported difficulty in climbing 10 steps without resting, or difficulty in walking 2 or 3 blocks outside on level ground * A score of 4 to 9 on the Short Physical Performance Battery (mild to moderate physical impairment) * Total serum testosterone level (TT) \< 350 ng/dL and \> 100 ng/dL * Without dementia (Mini-Mental State Examination \[MMSE\] score \> 24) Exclusion Criteria: * Use of testosterone, anabolic steroids, dehydroepiandrosterone (DHEA), androstenedione or recombinant growth hormone (rGH) in the past year * Alcohol or drug abuse * Use of anti-convulsants or glucocorticoids (equivalent to prednisone \> 20 mg/day) * Prostate cancer, breast cancer or other cancers with life expectancy \< 5 years * Limiting neuromuscular, joint or bone disease, or history of stroke with residual neurological problems * Any neurological condition that would impact cognitive functioning including: * epilepsy * multiple sclerosis * HIV * Parkinson's disease * stroke * other focal lesion * Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Axis I psychiatric disorder in past year or use of psychotropic medications in 6 months * Abnormal prostate examination; PSA \> 4 ng/mL; or BPH symptom score \> 21 * Unstable angina, New York (NY) class III or IV congestive heart failure or myocardial infarction within 3 months of entry * Abnormal laboratory values (at discretion of principal …